title: Distal femoral physeal growth arrest secondary to a cemented proximal femoral endoprosthetic replacement.
abstract: We report a case of spontaneous physeal growth arrest of the distal femur in a nine-year-old child with Ewing's sarcoma of the proximal femur treated with chemotherapy and endoprosthetic replacement. Owing to the extent of disuse osteoporosis at the time of surgery, the entire intramedullary canal up to the distal femoral physis was filled with cement. Three years later, the femur remained at its pre-operative length of 19 cm. Pre-operative calculations of further growth failed to account for the growth arrest, and the initial expandable growing prosthesis inserted has been revised to a longer one in order to address the leg-length discrepancy. To our knowledge, this is the only reported case of distal femoral physeal growth arrest following cemented endoprosthetic replacement of the proximal femur.
authors.affiliation: Royal Orthopaedic Hospital, NHS Foundation Trust, Bristol Road South, Northfield, Birmingham B31 2AP, UK. louie.gaston@nhs.net
authors.forename: C L
authors.initials: CL
authors.lastname: Gaston
authors.forename: R M
authors.initials: RM
authors.lastname: Tillman
authors.forename: R J
authors.initials: RJ
authors.lastname: Grimer
mesh_terms: D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects* / Q000379:methods; D002484:Cementation; D002648:Child; D005260:Female; D005266:Femoral Neoplasms / Q000601:surgery*; D005269:Femur / Q000000981:diagnostic imaging / Q000254:growth & development; D006130:Growth Disorders / Q000000981:diagnostic imaging / Q000209:etiology; D006132:Growth Plate / Q000254:growth & development* / Q000601:surgery; D006801:Humans; D007870:Leg Length Inequality / Q000000981:diagnostic imaging / Q000209:etiology*; D011859:Radiography; D012512:Sarcoma, Ewing / Q000601:surgery*