Histology of physeal injuries

The growth plate (physis) is responsible for providing and regulating longitudinal growth of the upper and lower limbs. This regulation occurs through interaction of the cells in the growth plate with systemic and locally produced factors. This complex interaction leads to precisely controlled changes in chondrocyte size, receptors and matrix, which will ultimately result in endochondral bone formation. With advances in cellular and molecular biology, our knowledge about these complex interactions has increased significantly during the past decade. Deficiency of any of the regulating factors or physeal injury during childhood can alter this well-orchestrated sequence of events and lead to abnormalities of growth. This review highlights the histology of normal physes, including recent findings at cellular and molecular levels, mechanics and mechanobiology of growth plate, pathologies that can affect the physis, and the treatment options including interposition materials.