A pilot study of short- and long-term sequelae to rigid fixation across metacarpal physes in a baboon model.
The use of rigid fixation for fractures of the extremities has become commonplace. The short- and long-term effects of rigid fixation on the growing hand, however, have not been studied thoroughly. In this project, the use of rigid fixation across metacarpal growth plates (physes) in growing primate hands was examined. The hypothesis to be tested was that long-term placement of rigid fixation devices across physes during stabilization of mid-shaft osteotomies will cause the physes to close prematurely. Fixation devices with screws placed in the epiphysis and left in place for 4 months or 1 year resulted in open physes, in support of the null hypothesis. However, in physes plated for 1 year, biochemical changes associated with increased bone differentiation were apparent. Findings suggest that rigid fixation across physes for as long as 1 year can be used appropriately in growing individuals when necessary. However, until additional investigation establishes whether the open physes are still capable of producing bone-lengthening hypertrophic chondrocytes, caution should be used in long-term placement of rigid fixation devices.
Opperman
L A
LA
Department of Biomedical Sciences, Baylor College of Dentistry, Texas A&M University System Health Sciences Center, Dallas, USA.
Drake
D B
DB
Kang
P
P
Nakeeb
S M
SM
Gammas
M
M
Morgan
R F
RF
D000818:Animals; D001860:Bone Plates; D001863:Bone Screws; D005260:Female; D006132:Growth Plate / Q000000981:diagnostic imaging / Q000601:surgery*; D007150:Immunohistochemistry; D008663:Metacarpus / Q000000981:diagnostic imaging / Q000378:metabolism / Q000601:surgery*; D010027:Osteotomy / Q000379:methods; D010215:Papio; D010865:Pilot Projects; D011859:Radiography; D015291:Transforming Growth Factors / Q000378:metabolism
D015291:Transforming Growth Factors