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Recovery from Epiphyseal Invagination: Sequel to an Unusual Complication of Scurvy
FREDERIC N. SILVERMAN
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From the Departments of Pediatrics and Radiology, The Children's Hospital and the Children's Hospital Research Foundation, Cincinnati
1970 by The Journal of Bone and Joint Surgery, Incorporated
The Journal of Bone & Joint Surgery.  1970; 52:384-390 
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Abstract

A typical separations of the distal femoral epiphysis was observed in a six-month-old infant with clinical and roentgenographic signs of scurvy. One year later, apparent premature union of the central portion of the epiphysis with the shaft was observed and subsequent growth disturbance was documented when the child was four years of age. At twenty-two years, however, almost complete recovery from the growth disturbance had occurred without compensatory overgrowth of other areas, and with only minor alterations in the configuration of the affected bone. Apparently, a transitory slowing or arrest of endochondral ossification had taken place in the central portion of the epiphysis and metaphysis with subsequent resumption of normal and accelerated growth, which resulted in restoration of nearly normal dimensions. In such a "ball-in-socket" epiphysis-shaft junction, closure of the plate may be apparent and not real. Careful serial studies are necessary before considering epiphyseodesis on the healthy side.

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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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