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Physeal bar equivalent

Peterson, Hamlet A.; Shaughnessy, William J.; Stans, Anthony A.

Journal of Pediatric Orthopaedics B: November 2017 - Volume 26 - Issue 6 - p 507–514
doi: 10.1097/BPB.0000000000000384

Premature partial physeal arrest without the formation of an osseous bar – physeal bar equivalent (PBE) – is uncommon. Four children with a PBE had an infection near the distal femoral physis before the age of 11 months. Some growth was achieved after resection of the PBE in each case. Of two cases diagnosed and treated early, one required only contralateral physeal arrests to achieve limb-length equality at maturity. The other, currently 8 years and 4 months old, has a 1.1-cm limb-length discrepancy 6 years after PBE resection and will require observation until maturity. Of two cases diagnosed and treated late, one required ipsilateral femoral lengthening and contralateral femoral shortening and physeal arrests to treat the limb-length discrepancy and angular deformity. The other, currently 7 years and 1 month old, has a 4.8-cm discrepancy and will need future surgical limb-length equalization. Early recognition and treatment of PBE is required to avoid severe limb-length inequality and angular deformity.

Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA

Correspondence to Hamlet A. Peterson, MD, Department of Orthopedic Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA Tel: +1 507 284 2691; e-mail:

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