Extension of growth-plate cartilage into the metaphysis: a sign of healing fracture in abused infants
Authors
Kleinman, Paul K.Marks, Jr., Sandy C.
Spevak, Melissa R.
Belanger, Patricia L.
Richmond, Joann M.
UMass Chan Affiliations
Department of RadiologyDocument Type
Journal ArticlePublication Date
1991-04-01Keywords
Child AbuseGrowth Plate
Humans
Infant
Tibia
Tibial Fractures
Wound Healing
Life Sciences
Medicine and Health Sciences
Metadata
Show full item recordAbstract
The present study was carried out to determine if healing metaphyseal injury in abused infants is accompanied by an increase in the thickness of the growth-plate zone of hypertrophic cartilage and if a radiolucent extension from the growth plate into the metaphysis correlates with this histologic indicator of healing fracture. The radiologic studies of 13 infants who died with evidence of inflicted injury were reviewed. Thirteen distal metaphyseal fractures were identified. Histologically, nine of these fractures were noted to be healing and four showed no evidence of healing. The nine healing injuries were accompanied by statistically significant thickening of the zone of hypertrophic cartilage. Seven of these demonstrated localized areas of hypertrophic cartilage extension; in six of these, corresponding radiolucent extensions of the growth plate into the metaphysis were seen. The extensions tended to be single and focal with minimal osseous injury and broad and multiple with extensive injury. No similar extension was visible in the four acute injuries. Because metaphyseal injuries are notoriously difficult to date, the presence of a reliable radiologic indicator of healing metaphyseal fracture can be important in the evaluation of infant abuse. Because the radiologic findings reflect the histologic alterations, extension of the growth-plate cartilage into the metaphysis may have implications for estimating fracture age.Source
AJR Am J Roentgenol. 1991 Apr;156(4):775-9.
DOI
10.2214/ajr.156.4.2003445Permanent Link to this Item
http://hdl.handle.net/20.500.14038/42319PubMed ID
2003445Related Resources
ae974a485f413a2113503eed53cd6c53
10.2214/ajr.156.4.2003445