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J Am Acad Orthop Surg, Vol 13, No 1, January/February 2005, 47-58.
© 2005 the American Academy of Orthopaedic Surgeons
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Physeal Bridge Resection

Khalid I. Khoshhal, FRCS, Edin, ABOS and Gerhard N. Kiefer, MD, FRCSC

Dr. Khoshhal is Assistant Professor and Consultant Pediatric Orthopedic Surgeon, Department of Orthopedics, King Khalid University Hospital, Riyadh, Saudi Arabia. Dr. Kiefer is Clinical Associate Professor, University of Calgary, and Director, Division of Pediatric Orthopedics, Alberta Children’s Hospital, Calgary, Alberta, Canada.

Reprint requests: Dr. Khoshhal, King Khalid University Hospital, PO Box 7805, Riyadh 11472, Saudi Arabia.

Growth arrest secondary to physeal bridge formation is an uncommon but well-recognized complication of physeal fractures and other injuries. Regardless of the underlying etiology, physeal bridges may cause angular and/or longitudinal growth disturbances, with progression dependent on the remaining physeal growth potential. Physeal bridge resection and insertion of interposition material releases the tethering effect of the bridge. Physeal bridge resection has become an accepted treatment option for patients with existing or developing deformity and for those with at least 2 years or 2 cm of growth remaining. Current experimental research is focused on the use of gene therapy and other factors that enhance chondrocyte proliferation to improve the management of growth arrest. The use of cartilage and cultured chondrocytes as interposition material after physeal bridge resection is an area of active research.






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