CLINICAL MANIFESTATIONS OF GROWTH ZONE MALFORMATIONS IN BLOUNT'S DISEASE AND KEITH'S SYNDROME
DOI:
https://doi.org/10.11603/1811-2471.2025.v.i4.15816Keywords:
bone, epiphyseal growth plate, macropreparation, blood supply, thigh, shinAbstract
SUMMARY. Pediatric orthopedics has its own scientific and practical features. The increase in the number of orthopedic pathologies is causing great damage to society. Analysis of the literature and our observations showed that many errors and complications are due to insufficient awareness of practicing doctors with the peculiarities of growth and formation of the bones of the children's skeleton and the role of the epiphyseal plate (EP) in the formation of many bone diseases. Untimely diagnosis, treatment and prevention cause the progression of the disease, reduce the quality of life of patients and require long-term treatment in adulthood.
The aim – to show the role of EP in the development of these ailments using the example of two orthopedic diseases, Blount's disease and Keith's syndrome, which are most often encountered by practicing doctors. To draw the attention of practicing doctors to the fact that morphofunctional changes in epiphyseal plasticity most often occur in the knee joint.
Material and Methods. Outpatient and inpatient documentation of children who were examined and treated in our institution was studied. The obtained data were compared with the results of examinations by other scientists over the past ten years. The basic method of bone examination was X-ray with standard equipment. Morphometry was also included, such as measurement of length, perimeter of limbs, axis of limbs when viewed from the front, side, back. In order to better understand the structure of the metaphyses and epiphyses of the femur and tibia, bone macropreparations of the knee joint were made. Photographs of the metaphyses, epiphyses and "facets" of the growth zones of the knee joint were taken.
Results. Based on a thorough study of outpatient and inpatient documentation, it was found that the most common orthopedic diseases caused by imbalance in EP growth were Blount's disease and Keith's syndrome. It should be noted that these diseases were most often localized in the anatomical area - the knee joint. On the prepared macropreparations of the distal metaphysis of the femur and the proximal metaphysis of the tibia, zones of extremely intensive blood supply to both the epiphyses and metaphyses of the named bones are clearly visible. The final cause of CB is unknown and is subject to further study. Keith's syndrome is a hereditary disease with a dominant type of inheritance.
Conclusions. The role of the epiphyseal plate in the process of bone growth and formation is dominant, especially in those topographic and anatomical areas that have intensive blood supply - the knee joint. The blood supply network of tubular bones is most pronounced in the distal metaphysis of the femur and the proximal metaphysis of the tibia. The dominant clinical forms of EP malformations are Blount's disease and bone exostoses (Keith’s syndrome).
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