Quotation from: Manual of Surgery

Written by: Alexander Miles and Alexis Thomson


The activity of the epiphysial cartilage may be modified as a result of
disease. In rickets, for example, the formation of new bone may take
place unequally, and may go on more rapidly in one half of the disc than
in the other, with the result that the axis of the shaft comes to
deviate from the normal, giving rise to knock-knee or bow-knee. In
bacterial diseases originating in the marrow, if the epiphysial junction
is directly involved in the destructive process, its bone-forming
functions may be retarded or abolished, and the subsequent growth of the
bone be seriously interfered with. On the other hand, if it is not
directly involved but is merely influenced by the proximity of an
infective focus, its bone-forming functions may be stimulated by the
diluted toxins and the growth of the bone in length exaggerated. In
paralysed limbs the growth from the epiphyses is usually little short of
the normal. The result of interference with growth is more injurious in
the lower than in the upper limb, because, from the functional point of
view, it is essential that the lower extremities should be approximately
of equal length. In the forearm or leg, where there are two parallel
bones, if the growth of one is arrested the continued growth of the
other results in a deviation of the hand or foot to one side.

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