[Periosteal bone resorption in the area of the metaphysis of growing bone as a precursor of epiphyseal injuries. A polarization optical and scanning electron microscopy study].
Macerated epiphyses of the growing infant bone exhibit an irregular surface which can already be observed at the macroscopic level. Polarizing microscopy demonstrates extended zones of bone resorption on the cortical surface, deductable from numerous lacunae of Howship. Ensuing experimentally induced epiphysiolyses, cortical bone fragments adhering to the inner surface of the periosteum are demonstrable by scanning electron microscopy. Having been torn out of the bone together with the periosteum, these cortical fragments leave corresponding defects on the bone surface. Due to the remodelling of the bone, involving the readjustment of the shape of the extremity, the attachment of the periosteum is relatively poor in the metaphyseal region of the growing bone. The influence of pathological forces can therefore easily cause a detaching of the periosteum in this region. The latter results in a significant weakening of the epiphyseal fastening in the zone between the epiphyseal plate and the metaphysis. The patterns of injury in the region of the growth plate are therefore essentially determined by the varying attachment of the periosteum to the metaphysis.
Dallek
M
M
Abteilung für Unfallchirurgie, Chirurgischen Universitätsklinik, Hamburg-Eppendorf.
Lorke
D
D
Meyer-Pannwitt
U
U
Jungbluth
K H
KH
D000293:Adolescent; D001862:Bone Resorption / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D004839:Epiphyses, Slipped / Q000473:pathology*; D006132:Growth Plate / Q000473:pathology; D006801:Humans; D007223:Infant; D008855:Microscopy, Electron, Scanning; D008859:Microscopy, Polarization; D010521:Periosteum / Q000473:pathology; D000072042:Salter-Harris Fractures
Die periostale Knochenresorption im metaphysären Bereich des wachsenden Knochens als Wegbereiter von Epiphysenverletzungen. Eine polarisationsoptische und rasterelektronenmikroskopische Studie.