Felis ISSN 2398-2950

Growth plate fracture repair

Synonym(s): Physeal fracture repair, Salter Harris fracture repair

Contributor(s): Neil Burton, James Cook, Noel Fitzpatrick

Introduction

  • Aim: prompt anatomical reduction and appropriate stabilization in an effort to maintain a straight limb of normal length and function.
  • Signs: growth plate fractures seen in immature animals.
  • With accurate reduction and appropriate fixation fractures heal rapidly in 2-4 weeks.
  • Intra-articular fractures should be repaired under compression to restore the articular surface and induce primary bone healing.

Classification

  • Fractures of the physis are divided into six types based on the classification by Salter Harris Salter-Harris classification of growth plate injury :
    • I - separation through the growth plate.
    • II - metaphyseal fragment remains attached to the epiphysis.
    • III - fracture through epiphysis into the growth plate.
    • IV - fracture through the epiphysis and metaphysis crossing the growth plate.
    • V - crush injury to the growth plate (may not be visible on radiographs).
    • VI - bridging of the growth plate by periosteal new bone.

Uses

  • Treatment of traumatic growth plate fracture, both high and low impact trauma Epiphyseal trauma.

Requirements

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Preparation

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Procedure

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Aftercare

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Outcomes

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Prognosis

  • Dependent on the site and configuration of the fracture, promptness of the surgical repair, quality of the repair and appropriate postoperative management.
  • Compensatory long bone growth can occur in cases of premature growth plate fusion following trauma or surgical repair.

Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Cook J L, Tomlinson J L & Reed A L (1999) Fluoroscopically guided closed reduction and internal fixation of fractures of the lateral portion of the humeral condyle: prospective clinical study of the technique and results in ten dogs. Vet Surg 28 (5), 315-321 PubMed.
  • Johnson J M, Johnson A L & Eurell J A (1994) Histological appearance of naturally occurring canine physeal fractures. Vet Surg 23 (2), 81-86 PubMed.
  • Prieur W D (1989) Management of growth plate injuries in puppies and kittens. JSAP 30 (11), 631-658 VetMedResource.


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