Treatment of Physeal Fractures

Question 1

what is the epiphysis?

Answer 1

end of a long bone
arises as secondary center of ossification

Question 2

how does longitudinal bone growth occur?

Answer 2

endochondral ossification

Question 3

where is the reserve zone?

Answer 3

adjacent to the epiphysis

Question 4

what is the physeal blood supply?

Answer 4

epiphyseal artery
metaphyseal artery

Question 5

disruption of the __________________ leads to necrosis of the germinal cells and permanent cessation of growth

Answer 5

epiphyseal blood supply

Question 6

where does a stress riser exist within the physis?

Answer 6

within hypertrophic zone

Question 7

what does a salter-harris type VI result in?

Answer 7

angular or rotational deformity

Question 8

what is a salter-harris type I?

Answer 8

fracture or separation through the hypertrophic zone

Question 9

what is a salter-harris type II?

Answer 9

fracture or separation through a portion of the hypertrophic zone and the metaphysis

Question 10

what is a salter-harris type V?

Answer 10

crushing injury of the physis

Question 11

what is the most common site of a salter-harris type V?

Answer 11

distal ulna

Question 12

does fixation that bridges the physis prevent bone growth?

Answer 12

yes

Question 13

when do the physes of the femur close?

Answer 13

by 6-9 months

Question 14

when is the prognosis guarded?

Answer 14

in animals with considerable growth potential

Question 15

what is the metaphysis?

Answer 15

wider shaft of the bone adjacent to the physis

Question 16

what is the physis divided into?

Answer 16

four zones

Question 17

what is the proliferating zone like?

Answer 17

cells divide in linear fashion
germinal cells are adjacent to the epiphysis

Question 18

what is the hypertrophic zone like?

Answer 18

broad flat cells
8x increase in cell volume
decrease in extracellular matrix

Question 19

what is the most common site of salter-harris type I?

Answer 19

femoral capital physis

Question 20

what is the most common site of salter-harris type II?

Answer 20

distal femur

Question 21

what is a salter-harris type IV?

Answer 21

fracture or separation through a portion of the hypertrophic zone, metaphysis, and epiphysis

Question 22

what does salter-harris type V result in?

Answer 22

necrosis of the resting layer of cartilage cells and therefore cessation of bone growth

Question 23

where do smooth pins damage the physis?

Answer 23

at the point at which they traverse
utilize small diameter pins

Question 24

when do the physes of the humerus close?

Answer 24

proximal 10-12 months
distal 6-7 months

Question 25

what predisposes the distal ulnar physis to salter-harris type V?

Answer 25

conical shape of physis

Question 26

what does premature closure of the distal ulnar physis result in?

Answer 26

shortening of ulna shortening of radius cranial bowing valgus external rotation elbow and carpal incongruity