Lower Extremity Physeal Bar Resection

Abstract When the normal cartilage of a growing physis is disrupted by injury or infection, it can heal with bone instead of cartilage, thereby forming a physeal bar. Physeal bars can cause angular or length deformities in the limbs of growing children and one way to surgically treat them, when recognized early enough, is with physeal bar resection to allow resumption of growth. A central physeal bar can be resected with computed tomography (CT) guidance using cannulated trephines and curettes and visualizing the resection cavity with an arthroscope prior to the central bar causing a significant limb length discrepancy. A peripheral physeal bar can be resected by direct open approach before the bar can cause a clinically significant angular deformity. This paper will detail these techniques for physeal bar resection.