What is physeal damage?

It is a combination of a horizontal fracture line through the physis and a vertical fracture line which runs from the growth plate through the epiphysis to the articular surface. Displaced injuries may result in a physeal bar, leading to growth disturbance and joint incongruity, leading to arthritis.

What causes a growth plate fracture?

Growth plate fractures often are caused by a fall or a blow to the limb, as might occur in: A car accident. Competitive sports, such as football, basketball, running, dancing or gymnastics. Recreational activities, such as biking, sledding, skiing or skateboarding.

Where is a Physeal fracture?

Physeal fractures are common; they make up 15-30% of all fractures in children. Common areas for fractures are the fingers, wrist, and lower leg. These often occur from an acute trauma, but stress fractures through the growth plate can be seen with chronic overuse, such as in gymnasts and pitchers.

What does physeal mean?

[ fĭz′ē-əl ] adj. Relating to the area of bone that separates the metaphysis and the epiphysis, in which the cartilage grows.

How can physeal injuries be classified?

Type I is a physeal separation without any bony injury. Type II has a metaphyseal extension – most common. Type III extends into the epiphysis (Intra-articular). Type IV has a fracture line that extends from the epiphysis through the physis to the metaphysis.

Is metaphysis and physeal the same?

Also known as a physeal separation, there is no extension into the metaphysis or epiphysis (Figure 4). If non-displaced, they can be difficult to diagnose on radiographs. In these cases, tenderness directly over the growth plate is the best indication of injury.

Is a metaphyseal fracture the same as an physeal fracture?

Metaphyseal fractures are fractures that involve the metaphysis of tubular bones. They may occur in pediatric or adult patients. Not all metaphyseal fractures intersect the physis. Even if a fracture does extend to the physis, it does not make it a Salter-Harris fracture.

What is a physeal fracture?

Physeal fractures (also called Salter-Harris fractures ) are important childhood fractures that involve the physis (physeal/growth plate). They are relatively common and important to differentiate from other injuries because the involvement of the physis may cause premature closure resulting in limb shortening and abnormal growth.

What factors contribute to the histologic pattern of physeal fractures?

The rate, direction, and magnitude of force are also factors that contribute to the histologic pattern of physeal fractures.

What are the causes of physeal injury?

Known vascular insult is a rare cause of physeal injury. 125 Partial or complete growth arrests can occur from a pure vascular injury to an extremity ( Fig. 7-8 ).

What is the significance of distal femoral physeal fractures?

Distal femoral physeal fractures are a good example of the overriding significance of the energy of injury in potential for subsequent growth disturbance. High-energy mechanisms of injury are frequent in this region, and the risk of subsequent growth disturbance is high. 99, 134