Abstract:
Growth and maturation occur in a predictable pattern throughout the body and within each individual bone. In the appendicular skeleton, endochondral ossification predominates in long bones and growth plates. The ends of these long bones are sites of relative weakness in the immature skeleton and prone to injury from acute insult and overuse. We present the normal histoanatomy and physiology of the growth plate complex, highlighting the unique contribution of each component and shared similarities between primary and secondary complexes. Components of the growth plate complex include the physis proper, subjacent vascularity within the growth cartilage, and the ossification front. The second section describes imaging considerations and features of normal and abnormal growth. Finally, we review the Salter-Harris classification for acute fractures and offer examples of characteristic overuse injury patterns involving the epiphyseal (proximal humerus and distal radius), apophyseal (medial epicondyle and tibial tubercle), and secondary growth plate complexes (medial femoral condyle and capitellar osteochondritis dissecans). This article provides a foundation and basic framework to better understand and anticipate potential complications and growth disturbances and to ensure optimal follow-up and early intervention when treatment can be less invasive.
摘要:
生长和成熟在整个身体和每个单独的骨骼内以可预测的模式发生。在附肢骨骼中,软骨内骨化在长骨和生长板中占主导地位。这些长骨的末端是未成熟骨骼中相对薄弱的部位,容易因急性损伤和过度使用而受伤。我们介绍了生长板复合体的正常组织解剖学和生理学,突出每个组件的独特贡献,以及初级和次级复合体之间的共同相似性。生长板复合体的成分包括适当的身体,生长软骨下的血管,和骨化面。第二部分描述了正常和异常生长的成像考虑和特征。最后,我们回顾了急性骨折的Salter-Harris分类,并提供了涉及骨phy(肱骨近端和桡骨远端)的特征性过度使用损伤模式的示例,前突(内侧上髁和胫骨结节),和次生生长板复合物(股骨内侧髁和颅骨剥脱性骨软骨炎)。本文提供了一个基础和基本框架,以更好地理解和预测潜在的并发症和生长障碍,并确保在治疗侵入性较小的情况下进行最佳随访和早期干预。