The The EpiphysisEpiphysis

Dr. Utsav Dr. Utsav AgrawalAgrawal

AnatomyAnatomy

A typical long A typical long bone consists bone consists of :of :

-Diaphysis -Diaphysis

-Metaphysis-Metaphysis

-Epiphysis-Epiphysis

Types of EpiphysisTypes of Epiphysis

Pressure epiphysesPressure epiphyses Traction epiphysesTraction epiphyses Atavistic epiphysesAtavistic epiphyses Aberrant epiphysesAberrant epiphyses

DevelopmentDevelopment

Epiphysis develop from secondary Epiphysis develop from secondary centres of ossificationcentres of ossification

They develop by process of They develop by process of enchondral ossificationenchondral ossification

Lesions at epiphysisLesions at epiphysis

chondroblastomachondroblastoma

giant cell tumourgiant cell tumour

intraosseous ganglionintraosseous ganglion

osteomyelitisosteomyelitis

clear cell clear cell chondrosarcomachondrosarcoma

OsteonecrosisOsteonecrosis

Osteochondritis Osteochondritis dessicansdessicans

Rare :Rare :osteosarcomaosteosarcomaaneurysmal bone cystaneurysmal bone cystbrown tumourbrown tumourhaemophilic pseudotumourhaemophilic pseudotumourenchondromaenchondroma

Epiphyseal plate injuriesEpiphyseal plate injuries

Classified byClassified by

-Polland-Polland

-Ogden-Ogden

-Salter-Harris-Salter-Harris Fractures involving the epiphyseal plate at the end of the Fractures involving the epiphyseal plate at the end of the

long bone of a growing childlong bone of a growing child Growth plate fractures account for 15-20% of major long Growth plate fractures account for 15-20% of major long

bone fractures and 34% of hand fractures in childhoodbone fractures and 34% of hand fractures in childhood Classified into 5 types based on fracture lineClassified into 5 types based on fracture line

Salter & Harris Classification ofSalter & Harris Classification ofEpiphyseal plate injuriesEpiphyseal plate injuries

Type I Type I

Slipped Capital Femoral EpiphysisSlipped Capital Femoral Epiphysis

Type IIType II

Type IIIType III

Type IVType IV

Type VType V

Rare types of Salter-Harris Rare types of Salter-Harris fracturesfractures

Type VI - Injury to the perichondral Type VI - Injury to the perichondral structuresstructures

Type VII - Isolated injury to the epiphyseal Type VII - Isolated injury to the epiphyseal plateplate

Type VIII - Isolated injury to the Type VIII - Isolated injury to the metaphysis, with a potential injury related metaphysis, with a potential injury related to endochondral ossificationto endochondral ossification

Type IX - Injury to the periosteum that Type IX - Injury to the periosteum that may interfere with membranous growthmay interfere with membranous growth

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