Acute and Chronic Growth Plate Injuries.

Abstract

1. Charlene Jones, MD* 2. Michael Wolf, MD†,‡ 3. Martin Herman, MD*,‡ 1. *Department of Orthopedic Surgery and 2. †Orthopedics, St. Christopher’s Hospital for Children, Philadelphia, PA 3. ‡Pediatrics and Orthopedic Surgery at Drexel University College of Medicine, Philadelphia, PA * Abbreviation: SH: : Salter-Harris 1. To deliver appropriate care to patients who have sustained acute or chronic growth plate injuries, clinicians should be able to identify the most common sites of injury, know the signs and symptoms associated with particular injuries, conduct a system-specific physical examination, obtain necessary radiologic data, and provide appropriate management. 2. Clinicians should be aware of common complications associated with growth plate injuries and understand when to refer patients to a specialist for further care. After completing this article, readers should be able to: 1. Identify the major anatomic areas of a long bone and recognize their importance in acute and chronic growth plate injuries. 2. Explain the mechanism of injury of growth plate injuries and its relation to the severity of injury. 3. Recognize clinical signs and symptoms of growth plate injuries. 4. Differentiate between the various types of Salter-Harris fracture classifications based on patient presentation, physical examination findings, and radiologic evidence. 5. Recognize the most common complications associated with Salter-Harris fractures. 6. Identify and diagnose various chronic growth plate injuries based on patient presentation, physical examination findings, and radiologic evidence. 7. Appropriately manage both acute and chronic growth plate injuries. 8. Know when to refer patients who have growth plate injuries to a specialist for further care. Growth plate injuries are commonly encountered by pediatricians. Growth plate trauma can occur acutely with an injury or chronically with repetitive stress. Injuries to growth plates are unique to those who are skeletally immature and warrant special attention for several reasons. Although most fractures of physes heal rapidly without any adverse effects, limb-length discrepancy from complete growth disturbance of a physis, angular limb deformities from incomplete physeal closure, and joint …