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Edmonds EW, Doan JD, Farnsworth CL. Periosteal incarceration versus interposition adipose tissue grafting in physeal fractures: pilot study in immature rabbits. J Exp Orthop. 2019;6(1):46doi: 10.1186/s40634-019-0214-4.
Edmonds, E. W., Doan, J. D., & Farnsworth, C. L. (2019). Periosteal incarceration versus interposition adipose tissue grafting in physeal fractures: pilot study in immature rabbits. Journal of experimental orthopaedics, 6(1), 46. https://doi.org/10.1186/s40634-019-0214-4
Edmonds, Eric W, et al. "Periosteal incarceration versus interposition adipose tissue grafting in physeal fractures: pilot study in immature rabbits." Journal of experimental orthopaedics vol. 6,1 (2019): 46. doi: https://doi.org/10.1186/s40634-019-0214-4
Edmonds EW, Doan JD, Farnsworth CL. Periosteal incarceration versus interposition adipose tissue grafting in physeal fractures: pilot study in immature rabbits. J Exp Orthop. 2019 Dec 01;6(1):46. doi: 10.1186/s40634-019-0214-4. PMID: 31788750; PMCID: PMC6885469.
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J Exp Orthop. 2019 Dec 01;6(1):46. doi: 10.1186/s40634-019-0214-4.

Periosteal incarceration versus interposition adipose tissue grafting in physeal fractures: pilot study in immature rabbits.

Journal of experimental orthopaedics

Eric W Edmonds, Joshua D Doan, Christine L Farnsworth

Affiliations

  1. Division of Orthopedic Surgery, Rady Children's Hospital, 3020 Children's Way, MC 5054, San Diego, CA, 92123, USA. [email protected].
  2. Department of Orthopaedic Surgery, University of California San Diego, 3020 Children's Way, MC 5054, San Diego, CA, 92123, USA. [email protected].
  3. Division of Orthopedic Surgery, Rady Children's Hospital, 3020 Children's Way, MC 5054, San Diego, CA, 92123, USA.

PMID: 31788750 PMCID: PMC6885469 DOI: 10.1186/s40634-019-0214-4

Abstract

PURPOSE: The purpose of this study is to evaluate bar formation following physeal fracture with incarcerated periosteum or adipose tissue graft using radiographic and histological methods in an immature rabbit model.

METHODS: Ten-week-old rabbits underwent induced proximal tibia physeal fractures with a contralateral sham. Fractures had periosteum (n = 5) or adipose tissue (n = 5) interposed. Radiographs were compared over time by tibial medial-lateral side difference (TMLSD)(mm), femoral-tibial angle and tibia plateau angle, and physeal bars evidence. MicroCT was performed, growth plates reconstructed, and physeal area calculated and normalized to same animal contralateral physes. Physeal disruption and chondrocyte organization were evaluated histologically.

RESULTS: Radiographic: After 6 weeks, physeal bars formed in both periosteum (4 of 4) and fat groups (3 of 5). The periosteum group showed a significant increase in the TMLSD between immediate post-op and 10 days later (p = 0.028); but, after 6 weeks, TMLSD change was not significantly different between the three groups (p = 0.161). MicroCT: The normalized physeal area of every physis in the fat group was more than 0.9 (0.99 ± 0.06). Only half of the periosteum group was over 0.9 (0.81 ± 0.24).

HISTOLOGY: Physeal disruption was seen by microscopic evaluation in none of the sham group, all 4 in the periosteum group and 4 of 5 in the fat group.

CONCLUSIONS: Fat interposition may prevent, or at least delay, the onset of bars across a fractured physis compared to periosteum, but it is not completely protective.

Keywords: Adipose tissue graft; Periosteum incarceration; Physeal bar formation; Physeal fracture; Rabbit fracture model

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