Percutaneous epiphysiodesis: experimental study and preliminary clinical results

An experimental study was conducted to determine the feasibility of using percutaneous drilling and pneumatic burring under image intensification to effect premature closure of the distal femoral epiphyseal plate in immature New Zealand white rabbits. Serial roentgenograms were made before the animals were killed at 6 or 10 weeks to document leg length inequality as compared with the contralateral leg following the procedure. Microscopic examination of nonoperated and operated epiphyseal plate revealed complete arrest of the operated epiphysis with bone fusion at the epiphyseal plate in eight of the nine rabbits. Since this animal study, 13 children have undergone percutaneous epiphysiodesis. Roentgenographically, all the growth plates appeared fused following the procedure. However, complete growth arrest cannot be substantiated until skeletal maturity. This is a preliminary report of a procedure that needs further documentation.