Felis ISSN 2398-2950

Epiphyseal trauma

Contributor(s): James Cook, Noel Fitzpatrick

Introduction

  • Epiphyseal fractures and separation of growth plates.
  • Cause: can be associated with low grade trauma, eg falls, as well as high velocity trauma, eg HBC (RTA) and high rise syndrome in cats.
  • Trauma may cause total or partial closure of growth plate(s).
  • Signs: major or minor deviation of limb, pain, swelling, non-weight bearing lameness.
  • Treatment: surgical. Restoration of alignment of articular surfaces essential.
  • Salter Harris classification of growth plate fractures  Salter-Harris classification of growth plate injury .
  • Displacement of fracture fragments more common than crush injuries in the cat.
  • Prognosis: fair to good provided correct anatomical alignment of articular surfaces.

Pathogenesis

Etiology

  • Trauma: high or low impact.

Pathophysiology

  • Variable outcome according to classification of fracture and location.
  • Salter-Harris type I and II most common, good prognosis, eg proximal and distal femur, proximal tibia  Salter-Harris classification of growth plate injury .
  • Salter-Harris type IV, poor prognosis unless accurate reduction and fixation, eg distal humerus (rare).
  • Salter-Harris type V, crush injury, premature closure and deformity or shortening inevitable, eg distal femur, distal radius and/or distal ulna.
  • Surgical implants should be smooth and placed with minimal trauma with as little deviation from the long axis of the bone as appropriate for type I, II, III and IV. May require lag screw fixation.
  • Implants that cross the open physis or synostosis may restrict normal growth   →   bone shortening or angulation, malarticulation of joints, limb deformity.

Diagnosis

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Treatment

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Outcomes

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Further Reading

Publications

Refereed papers


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