GROWTH RETARDATION AND FRACTURE HEALING

Growth retardation is defined as a child’s height being more than two standard deviations below the age-related average according to World Health Organization standards. This condition may arise from a variety of causes, including genetic syndromes, malnutrition, hormonal disorders (such as growth hormone or thyroid hormone deficiency), chronic systemic diseases (affecting the kidneys, liver, heart, or gastrointestinal tract), environmental factors, and psychological stress. Fracture healing in children is generally faster than in adults. This process includes the phases of inflammation, proliferation, and remodeling. However, in children with growth retardation, this process may be disrupted at any stage depending on the underlying cause. For instance, malnutrition reduces callus size and bone quali-ty; long-term steroid use suppresses osteoblast function and decreases bone density; hypothyroidism impairs endochondral ossification; and diabetes increases fragility through advanced glycation end products. Rare genetic disorders such as Gaucher disease, osteogenesis imperfecta, and hypophospha-tasia also lead to delayed and poor-quality fracture healing. This study examined the causes of growth retardation that affect fracture healing in detail, and experimental animal models or clinical case series were presented for each condition. The findings show that growth retardation often negatively af-fects fracture healing. Therefore, in pediatric patients presenting with fractures, physical examination, growth data, and family history should be thoroughly assessed. Timely diagnosis and treatment of any underlying systemic disease are critical to ensure proper fracture healing. In conclusion, fracture healing in children with growth retardation may be slower and more prone to complications. Hence, a holistic approach should be adopted in evaluating these patients, and families should be informed about the increased risk of fractures.