1. What is a growth plate?
A growth plate is an area of growth cartilage at the ends of tubular bones such as the femur (thigh bone), the humerus (upper arm bone), and phalanges (finger and toe bones). A growth plate actively grows a bone longer and is replaced by normal bone secondary to adolescent hormonal changes. Generally speaking, boys’ legs and arms stop growing at 16 years old and girls’ legs and arms stop growing at 14 years old because their growth plates “close” at those ages.
2. What is growth cartilage?
All of our bones start out as structures made of growth cartilage and gradually turn into bone starting when we are embryos and finishing when we are teenagers.
3. What is a growth plate injury? What is a growth plate fracture?
A growth plate fracture is a break in the bone that occurs at its growth plate. Most growth plate fractures heal completely without any long term bad consequences. In fact, growth plate injuries usually heal faster than breaks in parts of the bones that are distant from the growth plates. A small number of growth plate fractures cause growth plate “arrests.”
4. What does Salter-Harris mean?
The Salter-Harris classification system is the most common way orthopedists and other doctors classify growth plate fractures.
5. What is a growth plate arrest?
Fractures and other mechanisms such as frost-bite can cause a growth plate arrest. The cartilage at a growth plate is replaced by normal bone as a result of fracture healing. If normal bone replaces most or all of a growth plate that end of the bone stops growing (has a complete arrest). If normal bone replaces a portion of the growth plate, that end of the bone grows in the wrong direction (has a partial arrest).
6. What determines if a growth plate arrest occurs or does not occur as a result of a growth plate fracture?
There are many factors that can help the doctor determine the probability of a growth plate fracture resulting in an arrest. The biggest determinants are the site of the injury (which bone was broken) and the “energy of the injury” (how much force broke the growth plate). For example, fractures of the end of the ulna and the end of the femur commonly result in permanent growth plate injuries and injuries of the end of the radius or phalange growth plates hardly ever result in a growth plate arrest. Your pediatric orthopedists knows this subject thoroughly and will be able to fill you in with more detail regarding your child’s injury.
1. What is hip dysplasia?
Congenital Hip Dysplasia and Developmental Hip Dysplasia (DDH) are two names for the same condition. A baby with DDH has an abnormally shaped hip socket. The socket (acetabulum) in some cases is very “shallow” and cannot effectively contain the hip ball (femoral head) within itself. In other cases the socket is only slightly misshapen.
2. What is a congenital hip dislocation?
A “congenital hip dislocation” means that a baby’s femoral head is located outside of the socket where it is normally located.
3. What are the consequences of untreated DDH?
A baby with a hip dislocation or two dislocated hips will walk abnormally from the time she starts walking. The resulting walking deficit is very bad. A person who has hip dysplasia without a dislocation will develop arthritis at an early age.
4. How is DDH diagnosed?
In this country, primary care physicians screen babies for DDH. When your baby’s doctor is examining your baby’s hips she is evaluating her for DDH. Also the primary care physician asks you questions to see if the baby has DDH risk factors. If your family’s history, baby’s history, or your baby’s physical examination shows symptoms or signs concerning for hip dysplasia, you are usually referred for an ultrasound and/or a pediatric orthopedics consultation.
5. What is a Pavlik Harness?
A Pavlik Harness is the most common device pediatric orthopedists use to treat DDH. It looks like a set of baby over-alls. Babies tolerate them well. It maintains the baby’s hips in the position that the socket (acetabulum) best contains the femoral head (ball). A baby’s acetabulum is made of malleable growth cartilage and the socket molds around the ball into a normal shape over a 6 weeks to 3 months.
6. Does the Pavlik Harness work?
Almost always. The harness sometimes fails to correct true dislocations. Your pediatric orthopedic surgeon will progress to another treatment plan if the pavlik harness is not working.