الفهرس | Only 14 pages are availabe for public view |
Abstract Physeal bars represent an area of physeal growth arrest with subsequent bony bar formation across a portion of the physis. Growth arrest after fracture of the growth plate can result from compromised vascularity of the physis, damage to the germinal cells, and physeal bar formation between epiphyseal and metaphyseal bone. The size and location of physeal bar determine the kind of deformity that eventually develops. Complete growth arrest may produce limb length discrepancy without angular deformity. The amount of discrepancy depends on the growth rate of the affected physis and the age of the child. Partial growth arrest is often a more serious problem than complete arrest because partial arrest may result in length discrepancy combined with angular deformity, joint incongruity, or both. which will continue to increase so long as the patient is skeletally immature and the affected physis (or its contralateral counterpart) continues to grow. Physeal bar can be classified by etiology and by anatomic pattern. Potential etiologies of physeal bar are summarized in; physeal fracture, infantile Blount disease, infection, tumor, and irradiation. Three basic patterns of physeal bars are recognized : central, peripheral, and linear .Appropriate imaging is critical for the evaluation of a potential physeal bar. The CT or MRI images are used to create a map that illustrates the location and approximate cross-sectional area of the physeal bar. |