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Dear Scott, Now I could be wrong on this, but I assumed that as the tibial tuberosity has its own ossification centre, that it was therefore contributing to tibial growth. I am unable to re-check this in Grays as I am currently copying a CD for a friend, and am afraid that if I move the good book from under my stereo, that the CD will jump. Nick --- Scott Epsley <[log in to unmask]> wrote: > Dera Wendy, > thanks for your reply. This is a good discussion. > Nick, thanks for > your replies also. > What I was suggesting when I asked about US over an > apophysis > is that maybe by stimulating early ossification at > the apopysis > we might decrease the duration of the disorder. Now > I don't > necessarily believe this, but I'm throwing thoughts > out there > for people to digest. (Oh, by the way nick my > Gray's is right > here beside me, not under my Harry connick jr > collection!!). > I agree US is Contra over specialised tissues > because we are not > 100% sure of it's effects on these tissues. My > argument about > the apophysis is that it is not contributing to > growth of the > tibia, even though there is a connection to the > tibial epiphysis. > If the body makes bone (as nick suggested by the > presence of > calcification on x-ray, a finding I too have > observed) then this must > be in some way a profitable reaction, or the body > wouldn't do it > naturally. As to whether US would even be specific > enough to > do thisI have no idea, but I'm trying to expand our > thinking. > Maybe nick you have some other suggestions now that > I have > further explained myself? > scott. > > -- > > On Sun, 5 Mar 2000 03:47:21 Wendy Johnson wrote: > >I tend to assume that if a growthplate is still in > >situ then it has the potential to be active at that > >time and even if it were fully dormant would > >electrotharpy stimulate it? - whether that > stimulation > >would be adverse or not! > > > >In terms of using electrotherapy "as long as the > >growth plate is not in the line of fire" ... as I > >understand things shortwave-type modalities have a > >huge radius of 'fire' - the wavelength is 30 - 3 > >metres (Low and Reed, 1990), and although the > further > >the part is from the source of radiation the less > the > >intensity of radiation there is still the potential > of > >irradiating the whole body (!) to a certain extent > - > >all be it very small especially if low doses and > >pulsed applications are used. > > > >The other side of the argument is that these > >modalities have been used for many years now and > >hopefully if there were drastic effects they would > >have shown up etc. This said, I personally don't > think > >we know enough about risks and future risks. So I > >explain to any children, adolescents or their > parents > >that the full story isn't yet clear and that > >electrotherapy to a potentially still growing area/ > >person is not a techniques that I am prepared to > do. > >All of my patients thus far have been perfectly > happy > >with this explanation. > > > >I think we should use our own professional > judgement > >until more concrete evidence is there to guide us. > >Listen to the thoughts/ opinions of others but then > >digest them individually ourselves and don't be > afraid > >to question those thoughts and come to your own > >rational conclusions and open-ended conclusions. > > > > > >Wendy Johnson > > > >--- Lisa Woolley <[log in to unmask]> wrote: > >> An electrotherapy tutor advised me not to use > >> electrotherapy when the > >> individual growth plate is at it's most active > >> stage, but when is that? > >> Also it is safe to use as long as a growth plate > is > >> not in the line of > >> 'fire'. > >> > >> Lisa > >> > >> > >> >From: Wendy Johnson <[log in to unmask]> > >> >Reply-To: [log in to unmask] > >> >To: [log in to unmask] > >> >Subject: Re: Electrotherapy use on Children > >> >Date: Tue, 29 Feb 2000 14:12:33 -0800 (PST) > >> > > >> >I totally agree with the comments from Nick - > but > >> at > >> >what age should one start electrotherapy if > >> indicated > >> >... Grays anatomy states the ages at each growth > >> plate > >> >ossifies - e.g. the SIJ may only fully ossify at > >> >25years old! Personally I still go on the safety > >> side, > >> >but without further research I don't suppose > we'll > >> >have solid guidelines. > >> > > >> >Wendy Johnson > >> > > >> >--- nick bent <[log in to unmask]> wrote: > >> > > Dear Andy, > >> > > > >> > > I did a bit of a mini-literature search on > this > >> > > myself > >> > > recently and there is not much out there. The > >> > > trouble > >> > > is that it would probably be unethical to > expose > >> > > kid's > >> > > growth plates to electrotherapy in the > long-term > >> and > >> > > then see what happens. > >> > > However, > >> > > > >> > > Witlink et al (1995) exposed developing > >> metatarsal > >> > > rudiments of rats to ultrasound in vitro. > After > >> 4 > >> > > days > >> > > of pulsed rather than continuous ultrasound, > >> > > longitudinal growth was significantly > increased. > >> > > > >> > > Doyle and Smart (1963) demonstrated that > >> repeated > >> > > exposure of the growing epiphysis of the > femur > >> of > >> > > rats > >> > > to Shortwave diathermy increased the rate of > >> growth > >> > > compared to the untreated legs. > >> > > > >> > > Doyle and Smart (1963) Stimulation of bone > >> growth > >> > > by > >> > > shortwave diathermy. Journal of Bone and > Joint > >> > > Surgery. Vol. 45, No. A1, p15-23. > >> > > > >> > > Witlink et al (1995) Effect of therapeutic > >> > > ultrasound > >> > > on endochondral ossification. Ultrasound Med > >> Biol. > >> > > Vol. 21, No. 1, p121-7. > >> > > > >> > > Personally, I think that the fact that there > is > >> some > >> > > evidence to suggest alteration of bony growth > >> with > >> > > electrotherapy, weighed against the possible > >> > > benefits > >> > > of administering such treatments in > youngsters > >> who > >> > > should not need to be rushed back to action, > >> means > >> > > that it is sensible to go on the side of > safety. > >> > > > >> > > > >> > > Nick > >> > > > >> > > > >> > > --- Andy Thomas <[log in to unmask]> wrote: > >> > > > > >> > > > Is anybody aware of any research articles > >> related > >> > > to > === message truncated === __________________________________________________ Do You Yahoo!? Talk to your friends online with Yahoo! 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