physealsparing

Physiologic sparing is a surgical technique used in pediatric orthopedics. It aims to preserve the physis, commonly known as the growth plate, during surgical procedures. The physis is a crucial area of cartilage at the ends of long bones responsible for longitudinal bone growth. Injury or surgical disruption to the physis can lead to growth arrest, resulting in limb length discrepancies or deformities.

The principle behind physise-sparing surgery is to perform necessary interventions while minimizing damage to the delicate physis. This can involve using specialized instruments, careful dissection techniques, and avoiding direct manipulation or resection of the growth plate whenever possible. Surgeons employing this approach often consider the specific location and type of pathology, as well as the age of the child, to determine the feasibility and extent of physise-sparing.

Indications for physise-sparing surgery include certain fractures, osteomyelitis (bone infection), benign bone tumors, and some congenital deformities. The goal is to treat the condition effectively while safeguarding the child's future bone growth. While not always possible, a physise-sparing approach is generally preferred when indicated due to the potential long-term consequences of physis damage.

The benefits of successful physise-sparing surgery include the potential for normal or near-normal limb growth and alignment, reducing the need for subsequent corrective surgeries. However, challenges can arise, such as the technical difficulty of the procedures and the inherent risk of inadvertently injuring the physis despite best efforts. Close monitoring of growth and alignment post-operatively is essential to assess the outcome.