Injury to the epiphyseal plate.

Abstract

Epiphyseal plate or physis is a unique structure of the immature skeleton. It comprises chondrocytes in columnar formation. The chondrocyte maturation process in the physis is the responsible mechanism for longitudinal bone growth through endochondral ossification process. The blood supply to the physis can be divided to two major systems. Understanding of the injury to the physis and the blood supply is crucial for clinicians to effectively treat this particular injury in the childhood and adolescence. Injury classification scheme is based on radiographic appearances which lead to treatment planning and possible subsequent complications. Treatment of the physis injury requires the knowledge of these injury patterns of bone and its blood supply. Further investigations may be needed; each modality offers its own advantage and disadvantage in which clinicians must choose properly. Pretreatment counseling should be mandatorily offered to the patient and family members for their better understand of the treatment plan and to raise their awareness of possible complications.