THE IMPORTANCE OF GROWTH PLATES IN CHILDREN

Bone is a dynamic and complex structure involving the interaction of many cell and tissue types. The longitudinal growth of the skeleton is the result of endochondral ossification occurring in the growth plate. Through a sequential process involving cell proliferation, extracellular matrix synthesis, cellular hypertrophy, matrix mineralization, vascular invasion, and ultimately apoptosis, the cartilage model is continuously replaced by bone as the length increases. The epiphyseal growth plate is the ultimate target organ for longitudinal growth and arises from the cellular process of chondrocyte proliferation and differentiation. The growth plate consists of various essential components, including cartilage, bone, and fibrous elements, which work together to enable longitudinal bone growth. Two critical contributors to the function of the growth plate are growth factors and mechanical loading, which are particularly important for clinical applications. The regulation of longitudinal growth in the growth plate generally occurs through the close interaction of circulating systemic hormones and locally pro-duced peptide growth factors, the net result of which triggers changes in gene expression by growth plate chondrocytes. Any disruption in the development and physiology of the epiphysis leads to various skeletal abnormalities known as dysplasias.