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Orthopaedic Proceedings
Vol. 85-B, Issue SUPP_III | Pages 266 - 267
1 Mar 2003
Aykut U Yazici M Gedikoglu G Kandemir U Aksoy M Surat A
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Introduction: Prior to skeletal maturity temporary hemiepiphyseal stapling is a treatment method for angular deformities of long bones. The purpose of this study is to investigate the effects of temporary hemiepiphyseal stapling on the bone geometry and histology of physis.

Materials & Methods: Proximal medial epipyseal stapling of the right tibia were done in 46 New Zealand rabbits. 23 of them were euthanized at the end of 3 weeks. For the remaining 23 rabbits staples were fixed subperiostally (group A) in 11, and extraperiosteally (group B) in 12 rabbits. After 3 weeks the staples removed and the rabbits were euthanized at the end of 6 weeks. Bromodeoxyuridine used to evaluate cellular activity of the growth plate. Radiographs utilized for bone alignment.

Results: The articular surface-diaphysis angle was significantly increased at the end three weeks when compared to controls (27.7° vs. −1.5°, p:0.001). Cellular activity was decreased but preserved in the stapled tibias. At the end of six weeks while the angular deformity was worsening in group A 22.9° vs. 35.6°, p:0.001) it was improving in group B (23.2 ° vs. 14.6°, p:0.001). Bone tissue bridging the growth plate was noted in group A. Cellular activity in the group B was higher than group A at the end of six weeks.

Conclusion: Hemiepiphyseal stapling causes decreased cellular activity at the growth plate, which leads to angulation. With removal of staples, increased cellular activity at the growth plate results in the improvement of the deformity if staples were inserted extraperiosteally. Temporary extraperiosteal hemiepiphyseal stapling could be used as a safe and effective method for treatment of angular deformities prior to skeletal maturity.


Orthopaedic Proceedings
Vol. 85-B, Issue SUPP_III | Pages 256 - 256
1 Mar 2003
Omeroglu Hakan Ucar D Eren A Inan M Baktir A Aksoy M
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Purpose: The purpose of this study was to evaluate a possible correlation between DDH and lumbosacral spina bifida occulta (LSSBO).

Patients and Methods: This multicentric study included the assessment of anteroposterior pelvic radiographs of 415 adolescents and adults without any bilateral clinical and radiological hip joint abnormality and of latest radiographs of 291 adolescent and adult patients who had treated or untreated DDH which had occured unilaterally or bilaterally. Control group included 332 females and 83 males and mean age was 38±17 (12-70) years. DDH group included 246 females and 45 males and mean age was 30±17 (12-80) years.

Results: Female/male ratio of both groups was statistically similar (p=0.124). Rate of LSSBO was 12% and 23% in the control and DDH groups, respectively (p< 0.001). S1 and L5 vertebrae were the two most common involved sites in both groups. There wasn’t any significant correlation between the rate of LSSBO and the involved hip side in the DDH group (p=0.336). In females, rate of LSSBO was 9% and 23% in the control and DDH groups, respectively (p< 0.001). In males, rate of LSSBO was 22% and 24% in the control and DDH groups, respectively (p=0.893).

Conclusion: In females, DDH is significantly accompanied by LSSBO and LSSBO may be considered as a risk factor for DDH. Further intrauterine studies are needed for better understanding of this fact. It may be better to perfom ultrasonographic hip screening for the newborns who has an evident posterior vertebral arch defect without any intraspinal anomaly which has been seen during fetal ultrasonography.