Significance of corrective growth of opposite physes in the surgical correction of deformity following epiphyseal injury around the knee joint

Deformation due to growth disturbance after epiphyseal fractures around the knee may involve more than the primarily injured epiphysis, as spontaneous corrective growth of the opposite epiphyseal plate can take place in an attempt to maintain overall alignment of the leg. As a result, there will be an inclination in the knee joint line if corrective osteotomy is only performed for the primary angulation. We report two cases of this complex deformity in which corrective osteotomies of both the distal femur and the proximal tibia were performed, resulting in correct alignment of the overall leg axis and knee joint axis. Received: 25 May 1996 Accepted: 20 November 1996     

Magnetic resonance imaging of femoral head development in roentgenographically normal patients

Magnetic resonance images (MRI) of 22 patients with roentgenographically normal hips were reviewed retrospectively and the findings categorized according to age. With increasing maturity, the MR intensity of the femoral heads on spin echo images increased, as marrow fat became a dominant tissue in the head. The femoral head pattern was relatively inhomogeneous, with a broad band of diminished intensity extending in a posteromedial to anterolateral direction, corresponding to the pattern of trabecular bone. The femoral capital epiphyses were visible in younger patients as structures of bright intensity which remained evident through early adulthood. The articular cartilage of the hip joint was noted as a distinctive halo around the femoral head. An understanding of the MR pattern of the normal hip will aid in the early recognition of pathologic conditions, such as osteonecrosis.     

儿童桡骨远端骨骺损伤致尺骨撞击征一例报告

To investigate the clinical characteristics of ulnocarpal impingement syndrome in children induced by distal radial epiphyseal injuries in long term. A retrospective analysis of one child with distal radial epiphyseal injuries combined with dislocations was performed. The child had a sore wrist at 6 years after manual reduction. The diagnosis of ulnar impingement was conifrmed according to the patient history, symptoms, physical signs and radiological examinations of bilateral wrist joints. Ulnar impingement would occur in children with distal radial epiphyseal injuries in long term. Repeated manual reduction should be avoided in children with distal radial epiphyseal injuries, in order to minimize secondary epiphyseal injuries and reduce the risk of early epiphyseal closure. Furthermore, the growth imbalance of the ulna and radius in long term would be avoided and the risk of ulnar impingement in the wrist joint would be reduced. Clinical surgeons should pay great attention to the early diagnose and treatmont which could signiifcantly lower the disability rate.     

Tricho-rhino-phalangeal syndrome type I in a Belgian family

Summary We report three cases of tricho-rhino-phalangeal syndrome (TRPS) type I in a Belgian family. They presented typical characteristics such as a pear-shaped nose, and short, deformed fingers with cone-shaped epiphyses of some middle phalanges of the hands. Hair growth was practically normal in our patients, except for some narrowing of the lateral part of the eyebrows. Perthes-like hip dysplasia was documented in two of our cases. The proband presented at the age of 31 with Kienböch's disease of the right wrist. Blood and urine analysis showed no clear anomalies. In this patients, echography revealed a renal cyst containing a stone. The relationship of these findings to TRPS is discussed.     

肱骨远端全骺分离的诊断与治疗

自1998年1月—2002年1月我们诊治肱骨远端全骺分离21例，报告如下。     

发鼻指（趾）综合征（附一家族四例报告）

作者报告了一家族２代４例发鼻指（趾）综合征的临床Ｘ线表现。本综合征的病理基础是干骺软骨形成障碍伴外胚层发育不良。软骨发育障碍主要累及指（趾）骨的骨骺软骨板，导致锥形骨骺的形成及骺线早闭，肢端短粗畸形。结合文献讨论了本病的基本Ｘ线表现与病理基础。指出诊断要点和两髂骨耳状面三角形或月牙形骨质致密硬化可能是Ｘ线诊断的重要线索。     

Rotated Salter-Harris type II fracture of the phalanx

Abstract A Salter-Harris type II fracture with a rotational deformity involving the proximal phalanx of the ring finger is described for the first time. An undetected rotational deformity accompanying a Salter- Harris fracture compounds the fractures healing since it does not remodel, resulting in a malrotated union. Therefore, a cautious clinical and radiographic assessment is required, and fracture reduction should always be coupled with a correction of any evident rotational deformity.     

Dysplasia epiphysealis hemimelica—Trevor disease. Severe manifestations in a child

This report describes a case of dysplasia epiphysealis hemimelica with the first clinical manifestations at birth and increasing difference in the length of the lower extremities during infancy. The diagnosis was made at the age of 3 years when marked disability had already occurred. There was involvement of both legs and, to a lesser degree, the arms suggesting that this is a systemic disorder.Karl Gefferth (Budapest), the outstanding pediatric radiologist, in homor of his 80th birthday     

pTet-on骨骺干细胞株的建立和pTRE-甲状旁腺相关蛋白(1-36)反应质粒的构建

目的 建立pTet-on骨骺干细胞株,克隆甲状旁腺相关蛋白[PTHrP(1-36)]基因并构建反应质粒pTRE-PTHHrP(1-36).方法 用脂质体介导的基因转染技术将pTet-on质粒转染于永生化骨骺干细胞,G418筛选得到稳定克隆,再瞬时转染pTRE-2Hyg-Luc质粒并筛选出高水平诱导、低背景表达的永生化骨骺干细胞系.以RT-PCR方法获得带有酶切位点PTHrP(1-36)基因片段,与载体pTRE-2Hyg均双酶切后连接,转化扩增后对重组质粒进行提取和酶切、测序鉴定.结果 筛选到1株诱导后荧光素酶的表达活性增加50倍的骨骺干细胞系;经酶切图谱分析和DNA序列测定证实目的基因已经插入重组质粒.结论 筛选得到的永生化骨骺干细胞株受强力霉素诱导后能够低背景、高水平表达;成功克隆PTHrP(1-36)基因并构建了反应质粒pTRE-PTHrP(1-36),为进一步精确调控PTHrP(1-36)基因的表达奠定了基础.     

99Tcm-MDP SPECT/CT诊断骨骺早闭

目的 探讨⁹⁹Tc^m-MDP SPECT/CT诊断骨骺早闭的价值。方法 回顾性分析25例经X线平片随访确诊的骨骺早闭患儿⁹⁹Tc^m-MDP SPECT/CT资料,观察⁹⁹Tc^m-MDP SPECT/CT特征,评价其诊断骨骺早闭准确率。结果 25例骺早闭位于股骨近端1例、股骨远端11例、胫骨近端6例、胫骨远端7例。X线平片随访显示25例骺板均全部闭合。CT显示骨骺全部闭合11例,部分早闭6例,不能明确诊断8例;⁹⁹Tc^m-MDP SPECT/CT融合图像显示25例均为骺板全部闭合,患肢骺板软骨处无放射性浓聚或较淡斑片状放射性浓聚,诊断准确率为100%（25/25）。结论 ⁹⁹Tc^m-MDP SPECT/CT能早期准确显示骨骺早闭部位、程度和范围,为手术治疗提供重要依据。