Management of traumatic physeal growth arrest

Abstract

Physeal fractures account for approximately one third of all childhood fractures. Growth arrest is a serious complication of these injuries which, if not managed correctly, can lead to angular deformity, limb length discrepancy, or both. This in turn may cause pain, loss of function and disability. The article reviews the evaluation of a child with suspected traumatic physeal growth arrest including patient history, physical examination and imaging strategies for the early detection of physeal growth arrest and measurement of limb length discrepancy. Various anatomical classifications of physeal growth arrest are also presented. Finally, we discuss an approach to the management of a child with confirmed traumatic physeal growth arrest depending on the nature of the arrest and limb deformity.