A4 Growth plate fracture and disorders

Question 1

What are the two types of growth plate?

Answer 1

1. Pressure growth plates - found at the ends of long bones and responsible for most bone growth
2. Traction growth plates - found where muscle insert, or originate and these only contribute a little to bone growth

Question 2

What are the 5 types of growth plate fracture as described by Salter and Harris?

Answer 2

Type 1 - injury straight through the physis
Type 2 - Fracture through the physis and through the metaphysis (not articular)
Type 3 - Through the physis and epiphysis (articular)
Type 4 - Fracture of the epiphysis and metaphysis
Type 5 - crushing injury to the physis

Question 3

What are the 5 principles for corrective surgery for premature growth plate closure / angular limb deformity?

Answer 3

Restore joint congruity 
Restore to a functional position 
Correct rotation deformity 
Correct angular deformity
Restore limb length

Question 4

What is the difference between osteotomy and ostectomy?

Answer 4

Osteotomy - division of the bone

Ostectomy - resection of a piece of bone

Question 5

Do individual growth plates of the radius and ulna contribute equally to growth?

Answer 5

No. Proximal radius GP contributes to 40% of growth and distal radius GP to 60%. On the other hand, the distal ulna GP is 100% responsible for bone growth.

Question 6

5 possible consequences of premature ulna GP closure

Answer 6

1. Radius curvus
2. Carpal valgus
3. Rotation of paw
4. Joint incongruity
5. Abnormal limb length