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Functional Anatomy
Published in James Crossley, Functional Exercise and Rehabilitation, 2021
Bones are designed to provide solid attachment sites for muscles and absorb the stress and strain of movement. If we look at a typical long bone (see Figure 2.1), it has a head at each end, called the proximal and distal epiphysis, which is connected by a long diaphysis. The epiphysis is made up of spongy bone and is coated in hyaline articular cartilage, designed to absorb shock and support the gliding movement of joints.
Introduction and Review of Biological Background
Published in Luke R. Bucci, Nutrition Applied to Injury Rehabilitation and Sports Medicine, 2020
Epiphyseal bone is particularly susceptible to acute and chronic injuries, since the newly formed, immature bone is more similar to cartilage at the epiphysis. Fractures may occur on the epiphyseal line, through the epiphysis, or result in a crushed epiphysis. Subsequent bone formation may alter or stop bone growth, resulting in deformities. Chronic injuries to the epiphysis may lead to a slow, gradual degeneration with or without vascular necrosis (osteochondritis). Again, bone growth may be altered or cease, leading to deformity. Epiphyseal bone injury is a significant component in sports injuries of children and adolescents.
NBAS/RALF deficiency
Published in William L. Nyhan, Georg F. Hoffmann, Aida I. Al-Aqeel, Bruce A. Barshop, Atlas of Inherited Metabolic Diseases, 2020
Short stature is one of the most frequent findings in NBAS deficiency (Figure 106.2). The affected Yakuts had a mean SDS of height of -4.44 in females and -3.16 in males [1], in our study population, mean height was -2.64 SDS [3], the most severe case known to us however had a severe growth retardation with -6.10 SDS (despite a genetically determined body height of 0.89 SDS) (Figure 106.3). The severity of growth retardation seems to be associated with further skeletal features, such as thin bones and epiphyseal dysplasia with multiple phalangeal pseudo-epiphyses, reminiscent of a disturbance in bone mineralization. Two patients were found to have small cervical vertebrae (C1, C2) causing cervical instability [8]. Large fontanels with delayed closure, short neck, and abnormal thoracic configuration have also been described. There may be frequent or spontaneous fractures, even from the neonatal age on [5].
Application of 3D printing navigation system in pediatric epiphyseal complex lesion surgery
Published in Computer Assisted Surgery, 2023
Haoqi Cai, Haiqing Cai, Zhigang Wang
The most significant difference in the skeletal system between children and adults lies in the epiphysis and physeal plate and the epiphyseal complex [1]. Epiphyseal injury is a general term involving damage to the longitudinal growth mechanism of bone, including epiphysis, epiphyseal plate, ring around the epiphyseal plate (Ranvier area), growth-related articular cartilage, and metaphyseal injury. The incidence of epiphyseal injuries in children under 16 years of age ranges from 6% to 30% [2]. Innate metabolic diseases, infections, tumors and fractures may lead to epiphyseal damage [1,3]. According to statistics, about 5 to 10% of children experience growth failure after epiphyseal injury [2]. It mainly involves two aspects: abnormalities in limb length and abnormalities in limb alignment that will seriously affect children’s joint quality and walking function and then affect life quality [4–9]. They will be secondary to abnormalities in the spine, hip joints, and other joints over time [10].
Post-arthrolysis rehabilitation in a patient with wrist stiffness secondary to distal radio-ulnar fracture: A case report
Published in Physiotherapy Theory and Practice, 2023
Andrea Inglese, Sheila Santandrea
Fractures of the distal epiphysis of radius and ulna are among the most frequent (Ilyas and Jupiter, 2007). In relation to the severity of the fracture, after a traumatic event, the choice is between a conservative and a surgical approach. The correct diagnosis and subsequent early treatment are essential to avoid possible long-term consequences (Mathews and Chung, 2015). The most frequent complications cited are neuropathies, arthritis, malunion and rigidity (Gutow, 2005). Among the secondary complications, rigidity is an occurrence that can be promoted by a period of prolonged immobilization (Ikpeze, Smith, Lee, and Elfar, 2016; Wong, 2002) which could cause the reduction of physiological joint excursion (Wong, 2002). Arthrolysis is a surgical technique that can be performed via open surgery or arthroscopy (Guidi et al., 2021) which allows immediate postoperative rehabilitation (Luchetti, Atzei, and Fairplay, 2007; Luchetti, Atzei, and Papini Zorli, 2006). Since a wrist arthrolysis rehabilitation guideline was not available in the literature yet, it was suggested that the main goals for treatment should be maintenance of passive wrist range of motion (PROM), reduction of pain, as well as improvement of functional active range of motion (AROM) and social reintegration.
How long does it to achieve sagittal realignment of the displaced epiphysis in Salter-Harris type II distal radial fracture when treated by manual reduction?
Published in Journal of Plastic Surgery and Hand Surgery, 2023
Seung Hoo Lee, Hyun Dae Shin, Eun-Seok Choi, Soo Min Cha
We retrospectively reviewed 72 patients with SH type II distal radial epiphyseal injury who presented to our institution between 2005 and 2019. We obtained approval from the institutional review board. The inclusion criteria were SH type II distal radial fractures with dorsally displaced epiphysis and patient age ≤15 years at the time of injury. Patients who were followed up for <12 weeks, underwent operative treatment and presented at >7 days after injury were excluded. Finally, 56 patients with SH type II distal radial fractures of the displaced epiphysis were analysed. The mean age at the time of fracture was 10.7 years (range, 5–15 years). There were 41 boys (mean age: 11.3 ± 2.4 years) and 15 girls (mean age: 9.0 ± 2.4 years). The mean time from the occurrence of fracture to closed reduction was 1.4 days (range, 0–7 days), and the mean follow-up period was 20.1 months (range, 3–96 months). The injury mechanisms were as follows: fall-down (n = 25), soccer (n = 7), skate (n = 7), swing (n = 6), bicycle (n = 6), slip-down (n = 3), and ski (n = 2).