Fractures Pediatric Physis (Growth Plate)

Open growth plates in children are often involved in fractures. Diagnosis is made by radiography. Treatment is with closed reduction and immobilization or open reduction with internal fixation.

Bone growth takes place by tissue is added by the physäre disk (growth plate), which in turn through the metaphysis proximally and the epiphysis is delimited distally ((Salter-Harris classification of physären disc Wachstumsfugen-) fractures.). The age at which the growth plate is closed and the bone growth is complete, varies depending on the bone, but in any case this closing occurs later than the age of 20 years (epiphyseal plates (growth plates).).

Open growth plates in children are often involved in fractures. Diagnosis is made by radiography. Treatment is with closed reduction and immobilization or open reduction with internal fixation. Bone growth takes place by tissue is added by the physäre disk (growth plate), which in turn through the metaphysis proximally and the epiphysis is delimited distally ((Salter-Harris classification of physären disc Wachstumsfugen-) fractures.). The age at which the growth plate is closed and the bone growth is complete, varies depending on the bone, but in any case this closing occurs later than the age of 20 years (epiphyseal plates (growth plates).). The growth plate is the most fragile component of the bone and is thus regularly affected when a force is applied. Fractures of the growth plate can be extended in the metaphyseal and / or epiphysis; the different species are classified by means of the Salter-Harris system (Salter-Harris classification of physären disc (Wachstumsfugen-) fractures.). The risk of impaired growth increases to the extent that the fractures of type I to type V progress. In English, a useful reminder of these types SALTR: Salter I: S = Straight (the break line goes across a straight line through the growth plate) Salter II: A = Above (the break line spreads over the growth plate or away from) Salter III : L = Lower (the fault line extends below the growth plate) Salter IV: T = through (the fault line passing through the metaphysis, growth plate and epiphysis) Salter V: R = Rammed (the growth plate was dismembered) injuries that both the epiphysis as concern or even the growth plate (Salter types III and IV) these compress (Salter type V), tend to have a poor prognosis. Salter-Harris classification of physären disc (Wachstumsfugen-) fractures. Types I to IV are growth plates divisions; The growth plate is separated from the metaphysis. Type II is the most common type and V is the least likely. Epiphyseal plates (growth plates). The first numbers are the age at which the ossification first appears on the radiograph; the numbers in parentheses indicate the age in which the coalescence occurs. are diagnostic radiographs epiphyseal fractures should in children who have a localized tension and swelling in that area, or can not move or strain on the affected hip suspected. X-Plain radiographs are the investigation of choice. If the findings are not clear, x-rays from the opposite side for comparison can be helpful. Despite the use of comparison views radiographs may appear normal at Salter types I and V. If X-rays appear normal, but a fracture of the growth is suspected, it is believed that patients have a fracture and it will be applied a splint or a plaster, and patients should be checked again after a few days. Continue pains and tenderness indicate a fracture of the growth plate. Closed reduction therapy (if necessary) and immobilization or open reduction with internal fixation (ORIF), depending on the fracture Depending upon the particular fracture, is sufficient for types I and II usually a closed treatment; for types III and IV contrast, it often requires the ORIF therapy. Patients with type V injuries are in the hand of a pediatric orthopedist because such injuries almost always lead to stunted growth. Important Points Since the growth plate is more fragile in children, it is often destroyed before the stabilizing structures (eg. As head bands). The prognosis tends in children with Salter types III to be worse IV and V than in those with type I and II. Pull comparative X-ray images of the uninjured side into consideration if a fracture is suspected, but not to the X-ray images of is injured side visible. FFor the types III and IV contrast, it often requires the ORIF therapy.

Health Life Media Team

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