Fig. 15.1
(a–c) The oldest patient in our series was 15 y-o
Has the technique been employed in lytic lesions?
From: Becker, Münster
In: EMSOS, 1997 Meeting, Münster
Answer: Yes.
Osteogenic sarcoma and Ewing’s sarcoma, the two bone tumors most frequently seen in childhood, are not usually lytic lesions. However, we have successfully used the technique with lytic lesions such as telangiectatic osteosarcoma (see Fig. 11.11). In such cases, it is important to be sure that there is no pathological fracture.
Has the technique been employed in metaphyseal tumors which were seen to be in contact with the growth plate in the MRI scans?
From: Name unknown
In: SICOT, 1996 Meeting, Amsterdam
Answer: Yes.
The most important thing is to be sure that the tumor has not crossed the growth plate.
Has the technique been employed in benign lesions?
From Gabriel Mato, Portugal
In: Pediatric OrthopaedicMeeting, Aveiro, Portugal, 2015
Answer: We have not used the technique in such cases, but other colleagues (for instance, Julio de Pablos and colleagues at the Rizzoli Institute) have done so.
Does the retained growth plate remain active after the distraction procedure?
From: Marco Manfrini, Bologna
In: EMSOS, 1997 Meeting, Münster
Answer: In some cases.
As reported by De Pablos et al. from our department, if physeal distraction is used as a lengthening procedure, the growth plate may continue growing when lengthening is performed at a rate of 1–1.5 mm/day. In cases of epiphysiolysis for preserving the epiphysis, it is also possible that the growth plate will continue growing; Chap. 9 presents some cases that demonstrate subsequent growth. However, arrest of growth could be caused by other factors, such as, radiotherapy, delayed weight bearing, and the osteosynthesis device used for stabilization of the retained epiphysis (see Chap. 9).
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