 | Dr. Yost went to college, Graduate School and Medical School at the University of Nebraska and received an MD. He is Board Certified by the American Board of Orthopedic Surgeons. He not only treats athletes, but is an athlete as well. His interests are cycling, swimming and running and participates in Triathlons . He also recently became a member of the Kansas AOSSM which stands for American Orthopedic Society for Sports Medicine! |
Health & Rehabilitation
2012-11-07 11:47:31
Explaining growth plate injury
Q- What is a growth plate injury?
A- First things first…to understand a growth plate injury, let me first give you a better understanding of what a growth plate is:
Growth plates are the regions of the bone where growth occurs. They are located at the ends of the bones near the joints. The growth plate itself can be broken down into four separate layers or zones.
• Zone 1 is the resting zone and is made up of inactive cartilage cells.
• Zone 2 is the proliferative zone and is made up of actively growing cartilage cells.
• Zone 3 is the mature cartilage zone and is made up of enlarged mature cartilage cells that produce the cartilage matrix.
• Zone 4 is the zone of calcifying cartilage and is a thin layer where the cartilage cells have died and are surrounded by a calcified matrix. This is the weakest area of the growth plate and is where new bone is added.
Growth plate injuries/fractures are classified by the severity of the damage to the growth plate and effect on future growth.
• Type I fracture is a separation of the growth plate without involvement of bone. This occurs through the zone of calcification away from growing cartilage cells and usually heals without affecting future growth.
• Type II fracture involves separation of the growth plate in the zone of calcification…a variable distance, out through the adjoining bone. This is the most common type of growth plate fracture and is away from growing cartilage cells. It usually heals without affecting future growth.
• Type III fracture is through all layers of the growth plate and extends into the joint. This is an uncommon injury, but requires restoration of a normal joint surface. An operation is usually necessary.
• Type IV fracture occurs when the break extends from the joint surface through all layers of the growth plate and a portion of the bone on the other side. An operation is usually necessary to restore the joint surface and alignment of the growth plate.
• Type V fracture is the result of a crushing force through the growth plate. This is uncommon and usually involves the region around the knee or ankle. Initial x-rays may appear normal yet as the cartilage cells die from the crush injury, growth ceases. This injury has a poor prognosis but fortunately is uncommon.
The type of injury and age of child help to determine prognosis with a growth plate injury. The older the child (less growth left to occur) and the lower the fracture type, the better the prognosis.
