The Journal of Bone and Joint Surgery (American). 2008;90:1744-1750.
doi:10.2106/JBJS.G.01114
© 2008 The Journal of Bone and Joint Surgery, Inc.
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Endoscopic Surgery for Chronic Osteomyelitis Extending Across the Physis

A Report of Two Cases

Takashi Saisu, MD1, Makoto Kamegaya, MD1, Atsuya Watanabe, MD2, Nobuyasu Ochiai, MD3 and Kazuhisa Takahashi, MD3

1 Division of Orthopaedic Surgery, Chiba Children's Hospital, 579-1 Heta-cho, Midori-ku, Chiba 266-0007, Japan. E-mail address for T. Saisu: h-saisu@dc4.so-net.ne.jp
2 Department of Radiology, Teikyo University Chiba Medical Center, 3426-3 Anesaki, Ichihara 299-0111, Japan
3 Department of Orthopaedic Surgery, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba 260-8677, Japan

Investigation performed at the Division of Orthopaedic Surgery, Chiba Children's Hospital, Chiba, Japan

The first 150 words of the full text of this article appear below.


   Introduction
 
Physeal damage is difficult to avoid while surgically approaching a lesion that extends across the growth plate. For instance, an approach through the perichondral ring may cause serious injury to the physis. In particular, for lesions extending inside the epiphysis, preserving both the physis and the articular cartilage while also fully treating the lesion is difficult. Utilization of a technique similar to that of Langenskiöld1, with use of fluoroscopic guidance as well as direct vision, may facilitate a relatively less-invasive treatment of areas near the physis through fenestration of the metaphysis and reliance on mapping2 of the lesion site from preoperative diagnostic imaging. In practice, however, a surgeon usually operates with limited visibility during this procedure. With use of an endoscopic technique, we have effectively treated osteomyelitis involving the physis in two patients. The surgical technique and the treatment outcomes are reported here. The patients were informed that data . . . [Full Text of this Article]


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