Physeal fractures: basic science, assessment and acute management

Physeal fractures account for approximately one-third of all paediatric fractures. Although many of these injuries heal without negative sequelae, this fracture type is at risk of partial or complete growth arrest. The anatomy of the physis, and the basic science behind its growth and function are presented. We also present the epidemiology of physeal fractures, as well as outcomes following physeal injuries at various locations. General guidelines for treatment are discussed. A thorough understanding of the basic science, epidemiology, and treatment options for physeal fractures may help the clinician optimize management for children with this type of injury.