Growth & Maturation During Adolescence Dealing 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? –1–1. –2–2. –3–3.

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