Acute and Chronic Growth Plate Injuries

Jones, Charlene; Wolf, Michael; Herman, Martin J.

doi:10.1542/pir.2015-0160

Cited by 13 publications

(14 citation statements)

References 5 publications

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“…During periods of rapid growth, the growth plate is thicker and more fragile when compared with surrounding ligamentous and tendinous tissue. 7,11 It is interesting to note though that before and after a growth spurt the growth plate is actually more resistant to injury than the surrounding tissue when sprains and strains are more commonly seen. 11 It should also be remembered that fractures not in but near the growth plate may result in the opposite situation of growth arrest with stimulation of growth, especially in the femur and tibia.…”

Section: Growth Platementioning

confidence: 99%

“…Eighty percent of fractures occur in the middle third, 15% in the lateral third, and 5% in the medial third (Figure 15). 3,7…”

Section: Fracturesmentioning

confidence: 99%

“…In the young pediatric population a figure of 8 padded support is most commonly used, although a sling and swathe will suffice, especially in the very young for 4 to 6 weeks. 3,5,7 With nonoperative treatment union rates are expected in 95% to 100% of patients in this population.7 Adolescent patients should be seen by orthopedics as literature shows that operative managment for these fractures may have a superior functional outcome than nonoperative. 15 As so many neurovascular structures pass under the clavicle it is important to evaluate for compromise.…”

Section: Fracturesmentioning

confidence: 99%

“…Medial fractures or dislocations may have sternoclavicular joint pathology, accompanying rib fractures, brachial plexopathy, or chest wall injuries. 3,7 Fractures resulting in significant tenting of the skin or any sign of an open fracture should also be immediately seen by orthopedics. 5,7…”

Section: Fracturesmentioning

confidence: 99%

“…3,7 Fractures resulting in significant tenting of the skin or any sign of an open fracture should also be immediately seen by orthopedics. 5,7…”

Section: Fracturesmentioning

confidence: 99%

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Pediatric Sports-Related Injuries

Brown

Moran²

2018

Clin Pediatr (Phila)

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At any time there are millions of athletes ages 6 to 18 years participating in sports-related activities and the number is increasing. Unfortunately, the number of overuse injuries is also on the rise. This increase is most likely associated with single-sport specialization before the onset of puberty. As physicians and health care providers, we must educate these young athletes, their parents, and coaches to ensure safety. Short breaks are recommended and everyone involved should understand the athlete should not train more than 5 days per week and must take off 2 to 4 months per year consecutively depending on the specific sport and position on the team. To understand the complexity of these overuse injuries, it is important to have knowledge of the unique characteristics of the immature musculoskeletal system, periods of rapid growth, and the function of the growth plate, which is often involved in these injuries.

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Section: Growth Platementioning

confidence: 99%

“…Eighty percent of fractures occur in the middle third, 15% in the lateral third, and 5% in the medial third (Figure 15). 3,7…”

Section: Fracturesmentioning

confidence: 99%

Section: Fracturesmentioning

confidence: 99%

Section: Fracturesmentioning

confidence: 99%

“…3,7 Fractures resulting in significant tenting of the skin or any sign of an open fracture should also be immediately seen by orthopedics. 5,7…”

Section: Fracturesmentioning

confidence: 99%

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Pediatric Sports-Related Injuries

Brown

Moran²

2018

Clin Pediatr (Phila)

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Assessing the safety of an epiphyseal plate biopsy in a translational lamb model

Epperson

Williams

Rogers

et al. 2021

Journal Orthopaedic Research

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The literature demonstrates that obtaining a biopsy of the physis may be beneficial for diagnostic purposes. A small biopsy of the epiphyseal plate may allow for earlier detection of certain conditions and be used to monitor the healing of diseased and/or damaged physes. However, due to the fear of a growth arrest in a growing child, biopsies are not currently performed. In this study, we investigated the effects of a biopsy of the epiphyseal plate in 3‐month‐old lambs. A total of 4.2 mm biopsy samples were captured in the proximal tibiae and distal femora physes. The lambs were monitored 12‐ and 24‐week post‐biopsy. Computed tomography (CT) and micro‐CT scans were obtained to determine if any angular deformities occurred, while scanning electron microscope (SEM) and histological analysis were utilized to assess the bone response due to the biopsy. The contralateral limbs served as unaltered controls for direct comparison within each lamb. The data demonstrated no signs of angular deformities following a 4.2 mm biopsy of the physis. Bone growth/elongation was confirmed by CT, SEM, and fluorochrome analyses and indicated that the lambs were in fact immature and still growing at the time of the biopsy. Clinical Significance: This investigation demonstrated that a small biopsy of the epiphyseal plate can be obtained safely without the cause of growth arrest and angular deformities. The ability to precisely diagnose, treat, and/or monitor at‐risk children at an earlier timepoint by way of a biopsy sample could be an important advancement in regard to researching diseased and/or damaged physes.

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