Synonyms in a broader sense
Medical: juvenile fracture
- Forearm fracture
- Fracture
Introduction
The human skeleton is particularly at risk of fractures (medical fractures) in childhood. This is due to the fact that at this time the skeleton is still in the process of being built up. Thus, the so-called growth joint (med.
: epiphysis joint), which is responsible for the longitudinal growth of the bone, is not yet closed. The outer and inner periosteum (endosteum and periosteum) are also not yet fully mature. These play a major role in the thickness growth of the bones.
The weak points of the child’s skeleton lie everywhere here. If, in the event of a fracture, the bone parts are shifted laterally to each other or rotated against each other, these malpositions are spontaneously corrected during childhood as the bones grow. Because the longitudinal growth is not yet complete, the child’s bone still has the potential to grow and thus compensate for the malposition.
In colloquial language, this is referred to as “fused” (“growing together”). The extent of the potentially possible correction varies, however, depending on the age of the child, affected cooking and the type of malposition. After a fracture, a so-called spontaneous correction can occur.
However, if a fracture (fracture) is followed by an axial kink, the correction is more difficult. The greatest potential for correction is at the ulna and radius of the forearm. In contrast to lengthening – which can certainly be caused by fractures – which are not compensated, shortening can be corrected spontaneously in some cases.
In the case of a child’s fracture, there is always a risk of growth disturbance. Particularly in the case of fractures of the bone shaft or bone parts near the growth plate, stimulation of the latter can lead to extraordinary length growth of the bone. In about 70% of children with growth plate injuries, the additional length growth is 1 cm.
If the epiphysis joint (growth plate) is partially closed in the event of a fracture, this can lead to incorrect growth and shortening of the bones. The epiphyseal fugue consists of several zones in which different growth processes take place. The zone in the middle consists of cartilage and provides the cellular supply for the other cell zones (reserve zone).
The adjoining zone is the growth zone in which the cartilage cells form a columnar structure. This is followed by the so-called resorption zone. Here the cartilage cells increase in size by absorbing water.
This process contributes significantly to the longitudinal growth. In this zone, the cartilage is solidified and forms factors that stimulate blood vessels to develop. Now follows the ossification zone.
The cartilage is replaced by bone. The longitudinal growth is completed. If the epiphyseal fugue is closed, the longitudinal growth is also complete.
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