• The Journal of the Korean bone and joint tumor society
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• v.16 no.1
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• pp.37-41
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• 2010

A hemangioma occurred in the bony epiphysis is extremly rare. A 5-year-old boy visited to our hospital with pain and flexion contracture on the right knee. MRI showed some lesions scattered in the epiphysis of the distal femur and the proximal tibia. Biopsy specimen from the distal femoral epiphysis revealed pathologic findings compatible with hemangioma. On 8 years follow-up, the lesion in the distal femoral epiphysis had been cured, and those in the proximal tibial epiphysis were spontaneously disappeared without surgery. The scanogram shows no leg length discrepancy and angular deformity. We reports a rare case of hemangioma occurred in the bony epiphysis with the results of 8 year follow-up with the review of literatures.

• Korean Journal of Veterinary Research
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• v.46 no.3
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• pp.285-289
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• 2006

This study was performed to assess the growth plate closure time with aging in the Korean native goat. Radiographs of proximal and distal epiphysis of humerus, radius, ulna, femur and tibia were obtained at 2, 3, 4, 5, 6, 7, 8, 9, 11, 12, 13, 14, 17, 18, 20, 21, 30, 43 and 52 weeks after birth in 30 Korean native goats. The secondary ossification centers were scrutinized and assessed the maturity process on the basis of the criteria(stage 0 to 10). The secondary ossification centers of proximal and distal epiphysis of humerus, radius, femur and tibia and proximal ulna epiphysis appeared immediately after birth. While, that of distal ulna epiphysis appeared during the 1st to 2nd week of life. The fusion of distal humeral epiphysis occurred during the period from 8 to 12 months. The fusion of proximal radial epiphysis and distal tibial epiphysis were found at 1 year. The fusion of proximal and distal epiphysis of ulna and femur, proximal epiphysis of humerus and tibia and distal epiphysis of radius were found at 1 year or more than 1 year. As a result, growth plate closure was highly related to age in the Korean native goat and it is suggested that the estimation of animal's age might be useful by illustration of maturity process of the secondary ossification centers in the Korean native goat.

• Archives of Reconstructive Microsurgery
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• v.5 no.1
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• pp.106-111
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• 1996

Purpose : Propose a surgical technique in donor harvesting method in free vascularized proximal fibular epiphysis. Methodology : Concerned about growth potentials of the transplanted epiphysis in our long term results of the epiphyseal transplanted 13 cases more than 4 years follow-up, anterior tibial artery which contains anterior tibial recurrent artery is most reliable vessel to proximal fibular epiphysis which is the best donor of the free vascularized epiphyseal transplantation. In vascular anatomical aspect proximal fibular epiphysis norished by latearl inferior genicular artery from popliteal, posterior tibial recurrent artery and anterior tibial recurrent artery from anterior tibial artery and peroneal artery through metaphysis. The lateral inferior genicular artery is very small and difficult to isolate, peroneal artery from metaphysis through epiphyseal plate can not give enough blood supply to epiphysis itself. The anterior tibial artery which include anterior tibial recurrent and posterior tibial recurrent artery is the best choice in this procedure. But anterior tibial recurrent artery merge from within one inch from bifucating point of the anterior and posterior tibial arteries from popliteal artery. So it is very difficult to get enough vascular pedicle length to anastomose in recipient vessel without vein graft even harvested from bifucating point from popliteal artery. Authors took recipient artery from distal direction of anterior tibial artery after ligation of the proximal popliteal side vessel, which can get unlimited pedicle length and safer dissection of the harvesting proximal fibular epiphysis. Results : This harvesting procedure can performed supine position, direct anterolateral approach to proximal tibiofibular joint. Dissect and isolate the biceps muscle insertion from fibular head, micro-dissection is needed to identify the anterior tibial recurrent arteries to proximal epiphysis, soft tissue release down to distal and deeper plane to find main anterior tibial artery which overlying on interosseous membrane. Special care is needed to protect peroneal nerve damage which across the surgical field. Conclusions : Proximal fibular epiphyseal transplantation with distally directed anterior tibial artery harvesting technique is effective and easier dissect and versatile application with much longer arterial pedicle.

• Journal of Biomedical Engineering Research
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• v.33 no.2
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• pp.78-88
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• 2012

Knee joint instability by anterior cruciate ligament(ACL) rupture is allowing the abnormal loading condition at the tibial epiphysis locally, resulting in producing locally different bone bruise. The study examined difference between local alteration patterns of trabecular bone microarchitecture at medial and lateral parts of the tibial epiphysis by ACL rupture. Fourteen SD rats were divided into Control(CON; n = 7) and Anterior Cruciate Ligament Transection(ACLT; n = 7) groups. The tibial joints were then scanned by in vivo ${\mu}$-CT at 0, 4, and 8 weeks post-surgery. The results showed that alteration pattern on trabecular bone microarchitecture at medial part was significantly higher than that at lateral part of the tibial epiphysis in ACLT group from 0 to 8 weeks(P < 0.05). Tb.Th and Tb.Sp distributions were well corresponded with differences between aforementioned trabecular bone microarchitectural alteration pattens at medial and lateral parts of the tibial epiphysis in ACLT group from 0 to 8 weeks(P < 0.05). These findings suggest that the alteration patterns of trabecular bone microarchitecture should be locally and periodically considered, particularly with respect to the prediction of bone fracture risk by ACL rupture. Improved understanding of the alteration patterns at medial and lateral trabecular bone microarchitectures at the tibial epiphysis may assist in developing more targeted treatment interventions for knee joint instability secondary to ACL rupture.

• Journal of Korean Foot and Ankle Society
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• v.12 no.2
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• pp.180-184
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• 2008

Purpose: To evaluate the result of percutaneous fixation with cannulated screws and Ilizarov external fixator in triplane fracture of the distal tibial epiphysis in children. Materials and Methods: Between May 2004 and December 2007, 14 cases with triplane fractures were treated by percutaneous fixation with cannulated screws and Ilizarov external fixator after underwent CT imaging to assess the fracture pattern, articular disruption and to plan further management. Mean age and follow-up period were 14.1 years old and 15 months respectively. Results: There were satisfactory results in all 14 cases that had excellent reduction and stable fixation. All cases regained full range of movement within 6 weeks. Conclusion: We obtained satisfactory result after percutaneous fixation with cannulated screws and Ilizarov external fixator in triplane fractures of the distal tibial epiphysis in children.

• Journal of Yeungnam Medical Science
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• v.8 no.2
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• pp.121-127
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• 1991

We have reviewed seven cases of fracture-separation of the distal humeral epiphysis, one of which was initially misdiagnosed as a fracture of the lateral condyle. There were difficulties in making the diagnosis. The injury must be distinguished from an elbow dislocation and a fracture of the lateral humeral condyle. All seven patients revealed posteromedial displacenemt of the distal humeral epiphysis on initial x-rays. Three patients were treated by closed reduction and cast immmobilization, and four patients by open reduction and internal fixation. All three patients with conservative treatment had slight cubitus varus(under 5 degrees). Two patients with operative treatment had significant deformities of the elbow, one 25 degrees of valgus and one 20 degrees of varus. In treatment of these injuries, accurate evaluation of the state of reduction is most important. We got acceptable results with a conservative treatment.

• The Journal of the Korean bone and joint tumor society
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• v.14 no.1
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• pp.17-24
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• 2008

Purpose: Chondroblastoma is a rare benign bone tumor which occurs most frequently at epiphysis of long bones. This study analyzed the difference between patients with chondroblastoma either on their epiphysis or apophysis. Materials and Methods: We reviewed 19 patients with chondroblastoma who visited our hospital from August 1987 to August 2005. The mean follow up period was five years. Fifteen patients were male and 4 patients were female. The mean age of the patients was 17.6 years. The treatment consisted of either curettage alone, curettage with bone graft or curettage with cementation. We retrospectively compared the difference between one chondroblastoma originating from the epiphysis and the other chondroblastoma originating from the apophysis in terms of age predilection, duration of symptoms, size of tumor, status of the physis, presence of pathologic fracture, recurrence rate and accompanying aneurismal bone cyst. Results: Among the 19 patients, 11 patients had chondroblastoma at the epiphysis, and 8 at the apophysis. Distal femur was the most common site for epiphysis lesions while the greater trochanter was the most common site for lesions arising at the apophysis. The mean age was 14.2 years in the epiphysis group and 22.3 years in the apophysis group. Chondroblastoma occurred after closure of the physis in 3 out of 11 cases in the epiphysis group and in all 8 cases in the apophysis group showing a statistical significance between the groups in terms of status of the physis at onset. Size of the lesion was bigger in the apophysis group with statistical significance. Conclusion: Chondroblastoma is known to occur frequently at the epiphysis of long bones, but our study shows that in patients over 20 years old it occurs more frequently at the apophysis which needs to be considered when making the proper diagnosis. There was a significant difference between the two groups in terms of the age of occurrence, status of physis and size of tumor while there was none in terms of the duration of symptoms, presence of pathologic fracture, recurrence rate and presence of accompanying aneurismal bone cyst.

• Archives of Reconstructive Microsurgery
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• v.4 no.1
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• pp.16-22
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• 1995

We analyzed 11 children who underwent epiphyseal transplantation to the forearm for manage growing deformity ranged from 2 years 6 months to years(average 5 years 10 months) follow-up period. Etiologies of the functional impairment of the eleven were five traumatic, three congenital and three tumorous conditions. Lesions of epiphysis were distal radius in eight patients and distal ulna in three patients. Operation was performed with removal of non-functioning or deformed epiphysis followed by transplantation of free vascularized proximal fibular epiphysis with microvascular anastomesis. Evaluation was performed radiologically and functionally. The 9(81.8%) patients showed growth of transplanted epiphysis by radiological examination during follow up. At the last follow up, average growth rate was 0.86cm per year excepts 2 cases of no growth. Active wrist motion near normal to contralateral joint was achieved in 7 patients. In other 2 patients, active joint motion was improved but weaker than contralateral joint. Complications on donor site were two transient peroneal nerve palsy which have been resolved after 2 and 5 months post operation and one valgus ankle deformity. The ankle deformity was corrected with $Langenski\"{o}ld$ operation of the dital tibiofibular fusion. At recipient site, there was one superficial infection and it was easily controlled by systemic antibiotics. Many subsequent reports have described successful nonvascularized epiphyseal transplante, but overall results have been inconsistent and unsatisfactory. Other experimental and clinical studies in the transfer of vascularized epiphyses has encourage its clinical application. We also could gel successful growth in several cases with free vascularized epiphyseal transplantation.

• Journal of Yeungnam Medical Science
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• v.31 no.1
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• pp.61-64
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• 2014

Craniopharyngiomas are rare primary intracranial tumors. Despite their benign histological appearance, they are often associated with an unfavorable prognosis. The typical manifestations upon diagnosis are headache, visual impairment, polyuria/polydypsia, growth retardation, disturbance of pubertal development, and significant weight gain. The treatment options include radical surgery or radiotherapy, or a combination of these modalities. Slipped capital femoral epiphysis (SCFE) is the most common adolescent hip disorder. SCFE occurs when the capital femoral epiphysis displaces posteriorly on the femoral neck at the level of the physis. The etiology of SCFE is thought to be multifactorial and may include obesity, growth surges, and less common endocrine disorders. The related endocrine disorders include hypothyroidism, growth hormone supplementation, hypogonadism, and panhypopituitarism. Reported herein is a case of panhypopituitarism caused by craniopharyngioma combined with SCFE.

• Applied Microscopy
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• v.24 no.1
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• pp.59-76
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• 1994

Fine structure of the distal femoral epiphysis of growing mouse was studied by electron microscopy. The first morphological evidence of developing secondary center of ossification in the distal femoral epiphysis was found at newborn mouse. Ossification center was in the form of multiple foci of calcification and its cells were represented by remnant of degenerated cells within large lacunae that were separated by mineralized cartilaginous septa. Endochondral ossification beneath the articular cartilage proceeded in a less orderly manner than metaphyseal endochondral ossification. Columns of hypertrophied chondrocytes were not distinctly parallel to intercellular mineralized septa in all direction. Hypertrophied chondrocytes in the inner zone of the epiphseal center of ossification showed disintegrated. Resorption of mineralized cartilaginous septa was undertaken by perivascular cells and multinucleated chondroclasts. Resorption of the calcified cartilage was restricted to the region of ruffled border of the chondroclast. Growth along the metaphyseal side of the epiphyseal center of ossification was different from that along the articular surface. As the secondary center expanded toward the metaphyseal side, many vascular buds penetrated unmineralized cartilaginous septa and invaded viable chondrocytes. Many hypertrophied chondrocytes bodering the metaphyseal side of bone center remained viable after they became embedded in mineralized cartilaginous septa. This result suggested that the hypertrophied.