Introduction

INTRODUCTION

Immature skeletons heal rapidly and can remodel with growth but physeal injury or muscle imbalance may lead to progressive deformity . The conservative treatment of common conditions, such as developmental dysplasia of the hip (DDH), considers remodelling ability with an understanding of the Hueter– V olkmann principle and Wol ff ’s law ( Table 44.1 ): improving the biomechanical environment may reverse abnormal growth. In contrast, in conditions such as Blount’s disease, a poorly functioning growth plate leads to asymmetrical growth and deformity . Advances in genetics and molecular science have improved our understanding of certain conditions and may lead to new treatments. /uni25CF /uni25CF /uni25CF

TABLE 44.1 Laws governing the remodelling of bone. Hueter–Volkmann principle Compressive forces inhibit growth Tensile forces stimulate growth Wolff’s law Bone deposition and resorption depend on the stresses applied