The effect of hyperbaric oxygen on the transplantation of epiphysial growth cartilage in the rabbit.

Heller (1914) reimplanted epiphysial plates and had more success when a minimal amount of bone was attached to the cartilage. Haas (1915) was unable to record any growth after reimplantation. Silfverski#{246}ld (1934) also carried out reimplantation. Transplantation with reversal of the epiphysial plate was carried out by Heller (1917) and by Ring (l955a). Autotransplantation was performed by Heller (1914), Silfverski#{246}ld (1934), Pereira (1937), Bisgard (1939) and Lacroix (1951). More recently well planned experiments have been carried out by Ring (1955b) in which he compared groups of rabbits with autogenous and homogenous transplantation of epiphysial cartilages. Harris, Martin and Tile (1965) compared three groups: reimplantation, autogenous transplantation and homogenous transplantation. Clinical application of the procedure was first described by Straub (1929) who transplanted bone and epiphysial cartilage from a normal medial malleolus to the lower end of the opposite tibia, destroyed twoyears earlier by osteomyelitis. Fourteen years later, over that period ofgrowth, the further shortening was only 05 centimetre. Wenger (1945) described transplantation of the proximal 5 centimetres of the right fibula to the first metatarsal, destroyed four years earlier by osteomyelitis. Four years after the operation he recorded growth equal to that of the opposite metatarsal. Key (1949) described the complete removal and successful replacement of a fractured and dislocated radial head, with normal growth four years later. The use of the upper end of the fibula for congenital absence of the radius was described by Riordan (1955), although the difficulty of obtaining actual growth of the graft has been recently pointed out by Pulvertaft (1973). Wilson (1966) presented eleven cases of autogenous epiphysial transplantation to the hand and forearm. In one patient there was evidence of growth eight years after operation, and in two other cases growth was recorded two years after operation. Freeman (1959) reported a case of a successful graft to the thumb of a child aged twenty months which included epiphysial growth centres. He suggested that oxygenation of the graft might have been the critical factor and considered the possible value of hypothermia. Siffert (1966) pointed out that nutrients to the growth plate are transported from the perivascular spaces by diffusion through the highly hydrated cartilage matrix. He stated that after transplantation the epiphysis and plate usually failed to grow because of interruption of the Vascular supply to the epiphysis and therefore to the growth zone of the plate.