Premature physeal arrest, : A complication following a growth plate injury

Abstract

Physeal injuries are a common complication in pediatric trauma. While most cases resolve without consequence, a significant complication that can arise is premature physeal arrest, which results from the formation of a physeal bridge crossing the physis. Although this condition is relatively uncommon, it presents complex management challenges and, if left untreated, can lead to long-term morbidity such as limb length discrepancy and angular deformity. The primary pathophysiological process involves the development of a physeal bridge that disrupts normal bone growth. Early diagnosis is crucial and depends on careful patient follow-up after injury, supported by imaging modalities such as X-rays, CT scans, or MRI to assess the location and extent of the physeal bridge. Management strategies are tailored according to the size of the bar, the patient’s age, and the remaining growth potential. Treatment options include physeal bar resection, material transplantation, and, in cases of established deformity, corrective procedures such as osteotomy or limb lengthening. Thus this review aims to synthesize the current literature regarding the pathophysiology, diagnosis, and management strategies for premature physeal arrest following pediatric physeal injuries.