Compression injury of the epiphyseal growth plate: fact or fiction?

Abstract

It has been hypothesized that a longitudinal compression force on a growing long bone may cause partial or complete closure of a physis by crushing the germinal cell layer. In the absence of a fracture of the physis, the roentgenograms at the time of injury would be normal. Thus, this diagnosis can be made only in retrospect. In order to prove such a hypothesis, the following criteria would have to be met: (a) normal findings on roentgenograms taken in at least two planes at the time of injury, (b) no treatment, and (c) subsequent positive roentgenographic findings showing partial or complete closure of the physis, compared with the contralateral side. We have been unable to find, either in our files or in the literature, any cases that meet these criteria. Many other causes of premature closure of physes have been well documented in the literature.