儿童骨骼生长及损伤特点教学课件.ppt

In the ype III injury, the fracture line fracture through physis and extending through epiphysis, in this Anatomical reduction is recommended to restore the congruity of articular surface. . In the type IV injury, fracture line cross all zones of physis, causing the high risk of growth arrest, the precise anatomic reduction is recommended in this type Type V fracture will leading to the poor prognosis because of the crushing or compressing force, and sometime associted with long bone fx. Type VI is rare, Peripheral physeal injury at level of perichondral ring lead to the angular deformity. The physis have been divided into four zones: Resting zone, Proliferative zone, Hypertrophic zone, Provisional calcification zone Ok, the resting zone is widely dispersed chondrocyte and it’s the Source for continuous supply of chondrocytes to the proliferative zone Chondrocytes undergo mitosis and are organized into columns running parallel to the axis of bone growth in proliferative zone In the hypertrophic zone, the cells get enlarged 5-7 times,mineralization occurs between the chondrocytes colmns The periphery of the physis consists of 2 elements: the groove of Ranvier and the perichondrial ring Groove of Ranvier is a Triangular microscopic structure of periphery of the physis which Contain fibroblast, chondroblast, osteoblast Perichondral ring of LaCroix is a Fibrous structure overlying groove of Ranvier which mechanically stabilize epiphysis to metaphysis The main blood supply is from epiphyseal arteries, metaphyseal arteries and perichondral arteries There are two patterns of blood supply to epiphysis.Type A is … Tpye B is The other anatomic differences is the periosteum, the children’s periosteum is much thicker than the adults’ which produce callus more quickly. Now I will introduce the physiologic differences, the first is the Growth Remodeling because of the Asymmetric growth of physis and Wolff’s Law. The feature is most efficient in the younger chil