Growth & Maturation Growth & Maturation During AdolescenceDuring Adolescence

Growth & Maturation Growth & Maturation During AdolescenceDuring Adolescence

Dealing with the young patientDealing with the young patient

Introduction• Adolescence:

– Late maturing girls do better in sports….early maturing boys do worse in sports

• Physical concerns:

• Psychological Concerns:

Physical Issues• Development linked to

onset/stages of puberty– Tanner Stages I-V

• 40% of weight gain is during puberty

Tanner Stages of Development

• Male

• Female

GIRLS

BOYS

Bone Growth• Apophyseal Growth Plates:

• Epiphyseal Growth Plates:

Adolescent Bone Injury• Salter Harris Fx

– I-V: Determines the likelihood of growth interruption

• I. Pure physeal separation If non-displaced, jt effusion may be

only sign • II. Metaphyseal fracture + physeal separation   • III. Epiphyseal fracture + physeal separation   • IV. Fx through epiphysis + metaphysis   • V. Crush injury of physis (not detected acutely)

– Know when the growth plates close. Don’t want to miss Fx!

Salter Harris Fractures Classification

Growth plate closure

Adolescent Psychology• What are they thinking?

– 1.

– 2.

– 3.

Cognitive Development• 1. Early Adolescence (<14):

• 2. Middle Adolescence (15-17):

• 3. Late Adolescence (>18):

Summary• Puberty/Tanner Stages

• Bone growth & Fx

• Psychological & Cognitive development