Rebound growth after hemiepiphysiodesis may be a normal event, but little is known about its causes, incidence or factors related to its intensity. The aim of this study was to evaluate rebound growth under controlled experimental conditions. A total of 22 six-week-old rabbits underwent a medial proximal tibial hemiepiphysiodesis using a two-hole plate and screws. Temporal growth plate arrest was maintained for three weeks, and animals were killed at intervals ranging between three days and three weeks after removal of the device. The radiological angulation of the proximal tibia was studied at weekly intervals during and after hemiepiphysiodesis. A histological study of the retrieved proximal physis of the tibia was performed. The mean angulation achieved at three weeks was 34.7° (standard deviation (. sd). 3.4), and this remained unchanged for the study period of up to two weeks. By three weeks after removal of the implant the mean angulation had dropped to 28.2° (. sd. 1.8) (p < 0.001). Histologically, widening of the medial side was noted during the first two weeks. By three weeks this widening had substantially disappeared and the normal columnar structure was virtually re-established. In our rabbit model, rebound was an event of variable incidence and intensity and, when present, did not appear immediately after restoration of growth, but took some time to appear. Cite this article: Bone Joint J 2015;97-B:862–8

Aim. To investigate the effect of the eight plate position in sagittal plane on tibial slope in temporary epiphysiodesis technique applied to the proximal tibia and whether there is a rebound effect after removing the plate. Method. Forty New Zealand rabbits (6 weeks old) were divided into four groups. In all groups, two 1.3 mm mini plates and cortical screws implantation were placed on both medial and lateral side of the proximal epiphysis of the right tibia. In Group 1 and 3, the plates were placed on anterior of the proximal tibial anatomical axis in the sagittal plane, and placed posteriorly in Group 2 and 4. The left tibia was examined as control in all groups. Group 1 and Group 2 were sacrificed after four week-follow-up. In Group 3 and Group 4, the implants were removed four weeks after index surgery and the rabbits were followed four more weeks to investigate the rebound effect. The tibial slope was measured on lateral X-rays every two weeks. Both medial and lateral plateau slopes were evaluated on photos of the dissected tibia. Results. In Group 1, right MTPA (medial tibial plateau angle) and left MTPA, right LTPA (lateral tibial plateau angle) and left LTPA, and right 4wTPPA (the tibial proximal posterior angle at 4th week) and left 4wTPPA values were compared with each other. There was a significant difference in MTPA, LTPA, and 4wTPPA in Group 1 (p: 0.003, 0.006, 0.004). In Group 1, the medial and lateral slope significantly decreased after 4 weeks. There was no significant difference in MTPA, LTP and 4wTPPA measurements in Group 2 (p= 0.719, 0.306, 0.446, respectively). In Group 2, the slope did not change in four weeks. There was a significant difference in MTPA, LTPA, 4wTPPA, and 8wTPPA (tibial proximal posterior angle at 8th week) in Group 3 (p= 0.005, 0.002, <0.001, <0.001, respectively). In Group 3, the slope decreased at 4th week and remained stabile during the next four week-follow up and no rebound effect was observed. There was no significant difference in MTPA, LTPA, 4wTPPA, and 8wTPPA measurements in Group 4 (p= 0.791, 0.116, 0.232, 0.924), respectively. In group 4, slope did not change at 4th week of index surgery and no rebound effect was observed in the next four week-follow up. Conclusion. If eight plates were placed on anterior of lateral proximal tibia axis on both medial and lateral side, the tibial slope would reduce, and remain stabile after implant removal. Care should be taken to place the plates on the line of proximal tibial axis in sagittal plane in temporary epiphysiodesis technique performed due to angular knee deformities. Changing the slope due to plate placement can be used as a secondary gain for patients who will benefit from slope change, such as adolescent ACL surgery

The aim of this scoping review is to understand the extent and type of evidence in relation to the use of guided growth for correcting rotational deformities of long bones. Guided growth is routinely used to correct angular deformities in long bones in children. It has also been proven to be a viable method to correct rotational deformities, but the concept is not yet fully examined. Databases searched include Medline, Embase, Cochrane Library, Web of Science and Google Scholar. All identified citations were uploaded into Rayyan.ai and screened by at least two reviewers. The search resulted in 3569 hits. 14 studies were included: 1 review, 3 clinical trials and 10 pre-clinical trials. Clinical trials: a total of 21 children (32 femurs and 5 tibiae) were included. Surgical methods were 2 canulated screws connected by cable, PediPlates obliquely oriented, and separated Hinge Plates connected by FiberTape. Rotation was achieved in all but 1 child. Adverse effects reported include limb length discrepancy (LLD), knee stiffness and rebound of rotation after removal of tethers. 2 pre-clinical studies were ex-vivo studies, 1 using 8-plates on Sawbones and 1 using a novel z-shaped plates on human cadaver femurs. There were 5 lapine studies (2 using femoral plates, 2 using tibial plates and 1 using an external device on tibia), 1 ovine (external device on tibia), 1 bovine (screws and cable on metacarp) and a case-report on a dog that had an external device spanning from femur to tibia. Rotation was achieved in all studies. Adverse effects reported include implant extrusions, LLD, articular deformities, joint stiffness and rebound. All included studies conclude that guided growth is a viable treatment for rotational deformities of long bones, but there is great variation in models and surgical methods used, and in reported adverse effects

Objectives

Temperature is known to influence muscle physiology, with the velocity of shortening, relaxation and propagation all increasing with temperature. Scant data are available, however, regarding thermal influences on energy required to induce muscle damage.

We used a goat model of a contaminated musculoskeletal defect to determine the effectiveness of rapidly-resorbing calcium-sulphate pellets containing amikacin to reduce the local bacterial count. Our findings showed that this treatment eradicated the bacteria quickly, performed as well as standard polymethylmethacrylate mixed with an antibiotic and had many advantages over the latter. The pellets were prepared before surgery and absorbed completely. They released all of the antibiotic and did not require a subsequent operation for their removal. Our study indicated that locally administered antibiotics reduced bacteria within the wound rapidly. This method of treatment may have an important role in decreasing the rate of infection in contaminated wounds.