What Is The Epiphyseal Line

Epiphyseal plate
Radiogram of distal tibia (left) and fibula (correct) showing two epiphyseal plates.
Light micrograph of an undecalcified epiphyseal plate that is displaying the hypertrophic zone with its typical chondrocytes, matrix and iii zones: maturation (top), degenerative (middle) and provisional calcification (bottom).
Details
Identifiers
Latin	lamina epiphysialis
MeSH	D006132
TA98	A02.0.00.020
TA2	395
FMA	75427
Anatomical terminology [edit on Wikidata]

The epiphyseal plate (or epiphysial plate, physis, or growth plate) is a hyaline cartilage plate in the metaphysis at each end of a long bone. It is the part of a long bone where new bone growth takes identify; that is, the whole os is alive, with maintenance remodeling throughout its existing bone tissue, but the growth plate is the identify where the long bone grows longer (adds length).

The plate is simply plant in children and adolescents; in adults, who have stopped growing, the plate is replaced past an epiphyseal line. This replacement is known as epiphyseal closure or growth plate fusion. Complete fusion can occur every bit early as 12 for girls (with the most mutual being 14-15 years for girls) and equally early every bit xiv for boys (with the well-nigh common being 15–17 years for boys).^[1] ^[2] ^[3] ^[four] ^[5]

Construction [edit]

Development [edit]

Endochondral ossification is responsible for the initial bone evolution from cartilage in utero and infants and the longitudinal growth of long bones in the epiphyseal plate. The plate's chondrocytes are nether constant division by mitosis. These daughter cells stack facing the epiphysis while the older cells are pushed towards the diaphysis. Equally the older chondrocytes degenerate, osteoblasts ossify the remains to form new bone. In puberty increasing levels of estrogen, in both females and males, leads to increased apoptosis of chondrocytes in the epiphyseal plate.^[half-dozen] Depletion of chondrocytes due to apoptosis leads to less ossification and growth slows downwardly and subsequently stops when the entire cartilage take become replaced by bone, leaving only a thin epiphyseal scar which after disappears.^[7]

Histology [edit]

The growth plate has a very specific morphology in having a zonal arrangement as follows:^[viii]

Epiphyseal plate zone (from epiphysis to diaphysis)	Description
Zone of reserve	Quiescent chondrocytes are found at the epiphyseal end
Zone of proliferation	Chondrocytes undergo rapid mitosis under influence of growth hormone
Zone of maturation and hypertrophy	Chondrocytes stop mitosis, and brainstorm to hypertrophy by accumulating glycogen, lipids, and element of group i phosphatase
Zone of calcification	Chondrocytes undergo apoptosis. Cartilagenous matrix begins to calcify.
Zone of ossification	Osteoclasts and osteoblasts from the diaphyseal side intermission down the calcified cartilage and replace with mineralized bone tissue.

Masson Goldner trichrome stain of rabbit epiphysial plate.

Clinical significance [edit]

Defects in the development and continued sectionalisation of epiphyseal plates can lead to growth disorders collectively known as osteochondrodysplasia. The most common defect is achondroplasia, where there is a defect in cartilage formation. Achondroplasia is the nearly common cause of dwarfism or short stature and it also manifests in generalized deformities of bones and joints. Still, diverse other types of osteochondrodysplasias can crusade short stature and generalized deformities of basic and joints due to aberrant role of growth plate cartilage cells.^[9] Hereditary multiple exostoses is a genetic condition that is acquired by growth irregularities of the epiphyseal plates of the long bones of the upper^[10] and lower limbs.^[xi] It usually results in limb deformities and a sure degree of functional limitations.

Salter–Harris fractures are fractures involving epiphyseal plates and hence tend to interfere with growth, height or physiologic functions.^[12]

Osgood-Schlatter disease results from stress on the epiphyseal plate in the tibia, leading to backlog bone growth and a painful lump at the articulatio genus.

There are important clinical implications of the growth plate physiology. For example guided growth surgery, also known as temporary hemiepiphysiodesis is used to achieve correction or straightening of the bone deformities in a variety of pediatric orthopedic disorders such as Blount'south illness, rickets, arthrogryposis multiplex congenita and osteochondrodysplasias amongst others.^[13] ^[14] ^[fifteen] This applies to os and joint deformities in the coronal – medial/lateral – aeroplane or genu varum/genu valgum plane^[fourteen] and in the sagittal – anterior/posterior – airplane or articulatio genus flexion deformity/knee recurvatum plane.^[15]

Other animals [edit]

John Hunter studied growing chickens. He observed basic grew at the ends and thus demonstrated the existence of the epiphyseal plates. Hunter is considered the "father of the growth plate."^[16]

Run into also [edit]

Human development (biology)
Salter–Harris fracture

References [edit]

^ Crowder, C; Austin, D (September 2005). "Age ranges of epiphyseal fusion in the distal tibia and fibula of contemporary males and females". Periodical of Forensic Sciences. 50 (five): 1001–seven. doi:x.1520/JFS2004542. PMID 16225203. complete fusion in females occurs as early on as 12 years in the distal tibia and fibula. All females demonstrated complete fusion past 18 years with no significant differences betwixt ancestral groups. Complete fusion in males occurs as early as 14 years in both epiphyses. All males demonstrated complete fusion by 19 years
^ Barrell, Amanda. "At what age practise girls end growing?". MedicalNewsToday . Retrieved ix June 2020.
^ Jarret, Robert R. "Puberty: Tanner Stages – Boys". Pediatric HOUSECALLS . Retrieved nine June 2020.
^ Jarret, Robert R. "Puberty: Tanner Stages – Girls". Pediatric HOUSECALLS . Retrieved 9 June 2020.
^ "When do virtually males' growth plates close?". Zoodoc . Retrieved 9 June 2020.
^ Zhong, G; Carney, DH; Boyan, BD; Schwartz, Z (January 2011). "17β-Estradiol regulates rat growth plate chondrocyte apoptosis through a mitochondrial pathway not involving nitric oxide or MAPKs". Endocrinology. 152 (1): 82–92. doi:x.1210/en.2010-0509. PMID 21068162.
^ "Skeletal System / Bone Development and Growth". Archived from the original on 2008-07-09. Retrieved 2008-07-10 .
^ Ovalle, William K.; Nahirney, Patrick C. (2007). Netter's essential histology : with Pupil consult online access (1st ed.). Philadelphia, Pa.: Elsevier Saunders. ISBN9781929007868.
^ El-Sobky, TamerA; Shawky, RabahM; Sakr, HossamM; Elsayed, SolafM; Elsayed, NermineS; Ragheb, ShaimaaG; Gamal, Radwa (2017). "A systematized approach to radiographic cess of commonly seen genetic bone diseases in children: A pictorial review". Journal of Musculoskeletal Surgery and Enquiry. 1 (2): 25. doi:10.4103/jmsr.jmsr_28_17. S2CID 79825711.
^ Due east.L.-Sobky, Tamer A.; Samir, Shady; Atiyya, Ahmed Naeem; Mahmoud, Shady; Aly, Ahmad S.; Soliman, Ramy (2018). "Current paediatric orthopaedic do in hereditary multiple osteochondromas of the forearm: a systematic review". SICOT-J. 4: 10. doi:x.1051/sicotj/2018002. PMC5863686. PMID 29565244.
^ Duque Orozco, Maria del Pilar; Abousamra, Oussama; Rogers, Kenneth J.; Thacker, Mihir M. (July 2018). "Radiographic Analysis of the Pediatric Hip Patients With Hereditary Multiple Exostoses (HME)". Journal of Pediatric Orthopaedics. 38 (6): 305–311. doi:10.1097/BPO.0000000000000815. PMID 27328120. S2CID 23800752.
^ Mirghasemi, Alireza; Mohamadi, Amin; Ara, Ali Majles; Gabaran, Narges Rahimi; Sadat, Mir Mostafa (Nov 2009). "Completely displaced S-1/S-2 growth plate fracture in an adolescent: case written report and review of literature". Journal of Orthopaedic Trauma. 23 (10): 734–738. doi:ten.1097/BOT.0b013e3181a23d8b. ISSN 1531-2291. PMID 19858983. S2CID 6651435.
^ Journeau, P (2020). "Update on guided growth concepts around the knee in children". Orthop Traumatol Surg Res. S1877-0568 (xix): S171–S180. doi:ten.1016/j.otsr.2019.04.025. PMID 31669550.
^ ^a ^b EL-Sobky, TA; Samir, S; Baraka, MM; Fayyad, TA; Mahran, MA; Aly, Every bit; Amen, J; Mahmoud, S (1 Jan 2020). "Growth modulation for knee joint coronal plane deformities in children with nutritional rickets: A prospective series with treatment algorithm". JAAOS: Global Research and Reviews. 4 (ane): e19.00009. doi:x.5435/JAAOSGlobal-D-nineteen-00009. PMC7028784. PMID 32159063.
^ ^a ^b Trofimova, SI; Buklaev, DS; Petrova, EV; Mulevanova, SA (2016). "Guided growth for correction of knee flexion contracture in patients with arthrogryposis: preliminary results". Pediatric Traumatology, Orthopaedics and Reconstructive Surgery. 4 (four): 64–70. doi:x.17816/PTORS4464-70.
^ "Growth Plate (Physeal) Fractures". EMedicine.com. Retrieved 2008-01-15 .

External links [edit]

Normal bones at GetTheDiagnosis.org, showing the evolution of epiphyseal plates for different ages and bones.