Epiphyseal Plate Injury

[nicola]

Hi,

I was wondering if anyone could give me some information about epiphyseal plate injuries - it has been questioned weather a boy aged 14 has damaged his epiphyseal plate of his humerus I have no experience of this and am unsure what signs and symptoms would be seen? and does this even occur at the humerus?

The boy fell directly onto his shoulder twice whilst playing rugby 2 weeks ago and although has good RoM with slight pain only at EoR abduction and flexion he is complaining of giving way and poor ability to place weight through the arm - resisted testing shows pain on MR and LR at the GHJ.

There also is no pain on internal rotation or external rotation in abduction.

There is tenderness over the subscapularis and supraspinatus tendon.

These s+s lead me to think RC injury is the cause of the pain, however I feel unable to rule out the questioned epiphyseal plate injury with little knowledge about this.

Thankyou for any help

[Heidi]

Hi

I don't know a lot about this injury either. But I will try to help.

Who said there may be an epiphyseal plate injury? From what I know these are very rare injuries to occur in the humerus, they are normally femur or radius injuries.

The symptoms do sound like rotator cuff to me too, but if you have any doubt at all you should refer the patient for an x-ray to be on the safe side. Injuries to the growth plate can cause the bone to stop growing, especially if not treated suitably. Better to be safe than sorry.

Then when you know for definate you can progress your treatment for rotator cuff injury without worry.

Good luck!