Comparison of different methods used to inhibit physeal growth in a rabbit model.

A rabbit model was used to compare the rate, efficacy, and histologic appearance of physeal growth inhibition effected by Phemister epiphysiodesis, epiphyseal stapling, and percutaneous epiphysiodesis. Each technique led to an effective physeal closure, although the Phemister and staple methods produced more rapid deceleration of growth. A slower rate of physeal closure was seen after percutaneous epiphysiodesis, because this technique produced a gap in the bone that initially filled with fibrous tissue before forming bridges of trabecular bone leading to closure of the growth plate. Elevation of the periosteum alone produced an initial growth stimulation followed by early physiologic physeal closure. The amount of physis to ablate when doing a percutaneous epiphysiodesis is controversial. These results suggest that a percutaneous technique with limited physeal ablation, as used in the current study, effects slower rate of growth inhibition than that by the Phemister and staple techniques. A percutaneous technique that ablates a larger portion of the physis may be desirable to obtain more rapid growth inhibition.