Abstract
Growth and maturation occur in a predictable pattern throughout the body and within
each individual bone. In the appendicular skeleton, endochondral ossification predominates
in long bones and growth plates. The ends of these long bones are sites of relative
weakness in the immature skeleton and prone to injury from acute insult and overuse.
We present the normal histoanatomy and physiology of the growth plate complex, highlighting
the unique contribution of each component and shared similarities between primary
and secondary complexes. Components of the growth plate complex include the physis
proper, subjacent vascularity within the growth cartilage, and the ossification front.
The second section describes imaging considerations and features of normal and abnormal
growth. Finally, we review the Salter-Harris classification for acute fractures and
offer examples of characteristic overuse injury patterns involving the epiphyseal
(proximal humerus and distal radius), apophyseal (medial epicondyle and tibial tubercle),
and secondary growth plate complexes (medial femoral condyle and capitellar osteochondritis
dissecans). This article provides a foundation and basic framework to better understand
and anticipate potential complications and growth disturbances and to ensure optimal
follow-up and early intervention when treatment can be less invasive.
Keywords
growth distrubance - athlete - fracture - endochondral ossification - growth plate
