Histology
The germinal layer of the growing bone is on the epiphysis. Cells proliferate towards the metaphysis with more mature cells at that end ossifying.
Damage to the growing or proliferating part of the growth plate may result in premature halt of cell growth and bone growth.
Classification (Original)
Type I - fracture through the hypertrophic part of the physeal plate without involving the metaphysis or epiphysis.
Type II - fracture involving the metaphysis and physeal plate.
Type III - fracture involving the epiphysis and physeal plate.
Type IV - through and through fracture involving both epiphysis and metaphysis through the growth plate.
Type V - Crush injury of the physeal plate.
Other rarer types:
Type VI - Injury to perichondral stuctures.
Type VII - Isolated injury to epiphyseal plate.
Type VIII - Isolated injury to metaphysis with possible injury to endochondral ossification.
Type IX - Injury to periosteum that may interfere with membranous growth.
Prognosis and Complications
Type I and II are associated with better prognosis and usually require only conservative management.
Type III and above may require surgical intervention because of the potential complications of limb length discrepanciesor shortening, angulation of limbs, and intraarticular involvement that may result in chronic disability.
Future Topics:
- Fracture management in pediatrics
- Fractures specific to pediatric age groups (ie. Supracondylar fracture)
- CRITOE: Ossification in children
Credits:
Bevan, Chad, Slater-Harris Fractures, Power Point Slide, 2007.
