Epiphysiolysis ( novolat. Epiphyseolysis ; epiphysis + other Greek. Λύσις - decay, destruction) - Salter-Harris fracture (Salter-Harris) - destruction of sprouting epiphyseal cartilage . An important feature of this damage is the lengthy stop of bone growth, leading to asymmetry of the extremities in adulthood, for example, in case of a bone fracture with a shift of the pineal gland , rupture [1] .
| Epiphysiolysis | |
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 X-ray of the ankle with epiphysiolysis of the medial ankle . The black arrow is the line of fracture, white indicates the sprout zone . | |
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Epiphysiolysis in case of fracture along the bone growth zone occurs exclusively in childhood and adolescence until the closure of growth zones.
With osteoepiphysiolysis, the fracture line passes to the diaphysis .
Epiphysiolysis of the heads of the tubular bones is observed in patients with endocrine disorders, including growth hormone deficiency.
Types
There are nine types of fracture, 5 of which are described by Robert B Salter and W Robert Harris in 1963 [2] , the rest, more rare, are described later [3] :
- Type I - transverse fracture through the germ zone [4] : 6% of cases
- Type II - The fracture line passes through the sprout zone and metaphysis without affecting the pineal gland [5] : 75% of cases
- Type III - The fracture line passes through the sprout zone and pineal gland without affecting the metaphysis [6] : 8% of cases
- IV type - The fracture line passes through three elements of the bone: the sprout zone , metaphysis and pineal gland [7] : 10% of cases
- V type - Compression fracture of the germ zone, which appears on the roentgenogram as a decrease in its height (distance between the pineal gland and the diaphysis ) [8] : 1% of cases
- VI type - Damage to the peripheral portion of the germ zone, leading to the formation of a bone bridge and angular deformation of the limb (introduced in 1969 by Mercer Rang) [9]
- Type VII - Isolated damage to the germ zone (types VII — IX introduced in 1982 by JA Ogden) [10]
- VIII type - Isolated damage to the growth zone with a possible violation of the endochondral bone formation
- IX type - Damage to the periosteum with a possible violation of the endesmal bone formation
Epiphysiolysis Images
| Salter-Harris fracture x- ray with insets showing fracture lines | |||||||||
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Notes
- ↑ epiphysiolysis - “Medical Dictionary” (inaccessible link)
- ↑ Salter RB, Harris WR Injuries Involving the Epiphyseal Plate (Eng.) // Journal of Bone and Joint Surgery . - 1963. - Vol. 45 , no. 3 . - P. 587-622 . Archived on September 6, 2008.
- ↑ Fracture Imaging 412956 , Salter-Harris Fracture Imaging section on the EMedicine website
- ↑ SH Type I - Wheeless' Textbook of Orthopedics
- ↑ SH Type II - Wheeless' Textbook of Orthopedics
- ↑ Salter Harris Type III Frx - Wheeless' Textbook of Orthopedics
- ↑ Salter Harris: Type IV - Wheeless' Textbook of Orthopedics
- ↑ Type V - Wheeless' Textbook of Orthopedics
- ↑ The Growth Plate and Its Disorders. - Harcourt Brace / Churchill Livingstone, 1968. - ISBN 9780443005688 .
- ↑ JA Ogden. Skeletal growth mechanism injury patterns (neopr.) // J Pediatr Orthop. - 1982. - T. 2 , No. 4 . - S. 371-377 . - PMID 7142386 .