Skip to main content
The Ultrasound Journal
Download PDF

Volume 4 Supplement 1

8th WINFOCUS World Congress on Ultrasound in Emergency and Critical Care

What are the baseline measurements for physeal plate widths in healthy, uninjured children?

Critical Ultrasound Journal volume 4, Article number: A17 (2012) Cite this article

Background

There is limited data on the sonographic evaluation of normative physeal plate measurements in healthy, uninjured children.

Objectives

To determine the baseline measurements for physeal plate widths in healthy, uninjured children.

Methods

This is a prospective observational study of a convenience sample of healthy patients between ages 0 and 12 years presenting to the pediatric emergency department. A focused ultrasound of the distal tibia, fibula, radius and ulna were performed bilaterally (8 total). Measurements were taken at the physeal plates in the longitudinal plane at the widest distance. The degree of variance of physeal plate widths within an individual and the average values of physeal plates for each bone were calculated.

Results

A total of 60 patients were enrolled in this study. The mean age of enrolled patients was 6 years 3 months, 38% of who were female. Mean physeal plate diameters for the averaged measurement of each bone were: tibia 0.33 cm (95% CI 0.29 – 0.36), fibula 0.31 cm (95% CI 0.28 – 0.34), radius 0.27 cm (95% CI 0.24 – 0.30) and ulna 0.32 cm (95% CI 0.27 – 0.36). Mean values for the absolute difference in physeal plate diameters were: tibia 0.06 cm (95% CI 0.04 – 0.07), fibula 0.06 cm (95% CI 0.04 – 0.07), radius 0.05 cm (95% CI 0.04 – 0.07), and ulna 0.1 cm (95% CI 0.05 – 0.16). When measurements were stratified by age, the confidence intervals for each averaged measurement narrowed with increasing age while the absolute difference in physeal plate diameters remained consistent.

Conclusion

This pilot study demonstrated that there was no statistically significant difference in physeal plate diameters between contralateral extremities and the degree of variation between contralateral extremities was minimal. Results of this study elucidate normative growth plate variance in healthy children and demonstrate that mean plate measurements and absolute differences are narrow. This study suggests that sonographic detection of significant disparities in physeal plate diameters of injured children may have the potential for earlier detection of Salter Harris injuries with subsequent appropriate referral and management.

References

  1. Chamberlain JM, Patel KM, Pollack MM, et al.: Recalibration of the pediatric risk of admission score using a multi-institutional sample. Ann Emerg Med 2004, 43: 461. 10.1016/j.annemergmed.2003.08.001

    Article  PubMed  Google Scholar 

  2. Wilkins KE, Aroojis AJ: Incidence of fractures in children. In: Rockwood & Wilkins' Fractures in Children. 6th edition. Edited by: Beaty, JH, Kasser, JR. Lippincott Williams & Wilkins, Philadelphia; 2006:12.

    Google Scholar 

  3. Carson S, Woolridge DP, Colletti J, Kilgore K: Pediatric upper extremity injuries. Pediatr Clin North Am 2006, 53: 41. 10.1016/j.pcl.2005.10.003

    Article  PubMed  Google Scholar 

  4. Peterson HA, Madhok R, Benson JT, et al.: Physeal fractures: part 1. Epidemiology in Olmsted County, Minnesota, 1979–1988. J Pediatr Orthop 1994, 14: 423. 10.1097/01241398-199407000-00002

    Article  CAS  PubMed  Google Scholar 

  5. Sankar WN, Chen J, Kay RM, Skaggs DL: Incidence of occult fracture in children with acute ankle injuries. J Pediatr Orthop 2008,28(5):500–1. 10.1097/BPO.0b013e31817b9336

    Article  PubMed  Google Scholar 

  6. Simanovsky N, Hiller N, Leibner E, Simanovsky N: Sonographic detection of radiographically occult fractures in paediatric ankle injuries. Pediatr Radiol 2005,35(11):1062–5. 10.1007/s00247-005-1536-1

    Article  PubMed  Google Scholar 

  7. Farley FA, Kuhns L, Jacobson JA, DiPietro M: Ultrasound examination of ankle injuries in children. Journal of Pediatric Orthopedics 2001, 21: 604–607.

    CAS  PubMed  Google Scholar 

  8. Gleeson AP, Stuart MJ, Wilson B, Phillips B: Ultrasound assessment and conservative management of inversion injuries of the ankle in children: Plaster of paris vs. tubigrip. Journal of bone and joint surgery 1196, 78-B: 484–7.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. St. Luke’s Roosevelt Hospital Center, Department of Emergency Medicine, Division of Emergency Ultrasound, New York, NY, USA

    Lorraine Ng, JA Martin & RE Lewiss

Authors
  1. Lorraine Ng
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. JA Martin
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. RE Lewiss
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Lorraine Ng.

Rights and permissions

Open Access This article is distributed under the terms of the Creative Commons Attribution 2.0 International License (https://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Reprints and Permissions

About this article

Cite this article

Ng, L., Martin, J. & Lewiss, R. What are the baseline measurements for physeal plate widths in healthy, uninjured children?. Crit Ultrasound J 4 (Suppl 1), A17 (2012). https://doi.org/10.1186/2036-7902-4-S1-A17

Download citation

  • Published:

  • DOI: https://doi.org/10.1186/2036-7902-4-S1-A17

Keywords

  • Absolute Difference
  • Growth Plate
  • Injured Child
  • Distal Tibia
  • Focus Ultrasound