Free Vascularized Epiphyseal Transplantation, for Epiphyseal Injury in Children

Yoo, Myung Chul; Chung, Duke Whan; Han, Jung Soo; Shin, Moon Ho; Nha, Ki Nham

Abstract

It is difficult to treat the children with the growing deformity of long bone due toepiphysealloss or absence, because resulting deformith and discrepancy of limb length is progressive. There were many conventional treating methods including the lengthening and shortening, corrective osteotomy, and epiphysiodesis. But these procedures result in inadequate results, and there are limitation in treatment of these children. We tried the free vascularized epiphyseal transplantation using the proximal fibular epiphysis in 3 patients with epiphyseal injury or loss due to old tauma, wide excision of multiple exostosis and congenital clubhand. The duration of follow-up was from 20 months to 57 months, and the lengthening of the transplantedepiphyses was evaluated by the scanogram inregular interval. As final radiologic check, each transplanted epiphyseal growth was 1cm for 24months in case 1, 0.9 cm for 10 months in case 2, 1 cm for 24 months in case 3 (av. 1.3cm for 24 months) and the adjacent joint function was good. There was no gross deformity.