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Apophyseal And Epiphyseal Injuries (Main)
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Contents
Other Names
- Apophysitis
- Epiphysiolysis
Background
- This page is a description of the general principles of apophyseal and epiphyseal injuries in pediatric athlets
Pathophysiology
- Terminology
- Apophysis: normal secondary ossification center that is located in the non-weight-bearing part of the bone and eventually fuses with it over time
- Site of a ligament or tendon attachment
- Often the weakest point in biomechanical chain
- Epiphysis: component of bone above the physis
- Typically contributes to a joint
- Apophysitis: inflammation of the apophysis
- Epiphysiolysis: stress injury of the epiphyseal cartilage
- Apophysis: normal secondary ossification center that is located in the non-weight-bearing part of the bone and eventually fuses with it over time
Etiology
- General
- Occurs due to repetitive stress
- Force outweighs ability of structure to withstand the stress
Risk Factors
- Intrinsic
- Imbalances or deficits in strength and flexibility
- Poor technique or mechanics
- Normal variants of anatomic alignment
- Extrinsic
- Rapid increase in training (FIT, Frequency, Intensity, Time)
- Long-term, high training volume Goal: hours/week < age in years
- Suboptimal equipment
- Poor training surfaces or sudden change in training surface
- Early sport specialization
Differential Diagnosis
Epiphyseal Fractures (Salter-Harris Fractures)
- See: Epiphyseal Fractures
Apophyseal and Epiphyseal Avulsion Fractures
- Shoulder
- Elbow
- Hand and Wrist
- Spine
- Pelvis and Hip
- Knee
- Foot
Apophysitis and Epiphysitis
- Shoulder
- Humeral Head Epiphysiolysis (Little League Shoulder)
- Elbow
- Medial Epicondyle Apophysitis (Little League Elbow)
- Olecranon Apophysitis
- Wrist
- Distal Radial Epiphysitis (Gymnast's Wrist)
- Hip
- Knee
- Patellar Apophysitis (Sinding-Larsen-Johnansson Disease)
- Tibial Tuberosity Apophysitis (Osgood-Schalatter's Disease)
- Foot/ Ankle
- Posterior Calcaneus Apophysitis (Sever's Disease)
- Fifth Metatarsal Apophysitis (Iselin's Disease)
Clinical Features
- History
- Chronic
- Insidious onset
- Intermittent
- Worse with activities
- Improved with rest
- Physical Exam: (See: Physical Exam (Main))
Evaluation
Classification
Management
Return to Play
Complications
See Also
References
Created by:
John Kiel on 30 June 2019 20:00:01
Authors:
Last edited:
25 January 2022 16:29:29
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