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Mnemonics, Simplified Concepts & Thoughts

Anatomy of Physis (Growth Plate)

Epomedicine, Jul 30, 2024Jul 30, 2024

Last updated on July 30, 2024

Periphery of physis:

The physis is connected to the epiphysis and metaphysis peripherally via:

  1. Groove of Ranvier (supplies chondrocytes to the periphery for latitudinal or appositional growth)
  2. Perichondral ring of LaCroix (strong fibrous tissue that anchors physis to metaphysis)

Blood supply of physis:

There are three sources of blood supply to the physis: the epiphyseal, metaphyseal, and perichondral circulations. 

physis zones
38.8: Bone – Growth of Bone (LibreTexts libraries) [CC-BY-SA 4.0]

Zones of physis:

ZonesCharacteristicsFunctionsBlood supplyDiseases
EpiphysisEpiphyseal arteryMultiple Epiphyseal Dysplasia (MED)
Physis
1. Reserve (Resting) zoneGerminal cells of stem cell origin (responsive to hormones) surrounded by mechanically strong thick layer of matrixMatrix production

Storage
Epiphyseal arteries descend through the layer but do not supply (low oxygen tension)1. Diastrophic dysplasia
2. Pseudo-achondroplasia
3. Gaucher’s disease
2. Proliferative (Columnar) zoneStacking of chondrocytes longitudinally; surrounded by mechanically strong thick layer of matrixMatrix production

Cellular proliferation
Excellent (excellent oxygen tension)1. Achondroplasia
2. Hypo-achondroplasia
3. Gigantism
3. Hypertrophic zoneHypertrophy of chondrocytes (5-10 times) with less space for matrix (weakest layer)SCFE (non-renal failure)

Enchondroma
a. Maturation zonePreparation of matrix for calcificationLow (low oxygen tension)Mucopolysaccharidosis
b. Degenerative zonePreparation of matrix for calcificationLower (lower oxygen tension)Mucopolysaccharidosis
c. Zone of provisional calcificationProgrammed cell death of chondrocytesCalcification of matrixNil (poor oxygen tension)1. Rickets & Osteomalacia
2. Physeal fractures
MetaphysisMetaphyseal & nutrient artery branches
1. Primary spongiosaBone formationGood (good oxygen tension)1. Metaphyseal chondrodysplasia
2. Acute hematogenous osteomyelitis
3. Corner fractures
4. SCFE (renal failure)
2. Secondary spongiosaRemodelingExcellent (excellent oxygen tension)1. Osteopetrosis
2. Osteogenesis imperfecta
3. Scurvy
4. Metaphyseal dysplasia

The hypertrophic zone is therefore the weakest layer of the physis under tension, shear, and bending stress, and it is the most common area for fractures. 

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PGMEE, MRCS, USMLE, MBBS, MD/MS AnatomyMusculoskeletal systemOrthopedics

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Epomedicine. Anatomy of Physis (Growth Plate) [Internet]. Epomedicine; 2024 Jul 30 [cited 2025 May 9]. Available from: https://epomedicine.com/medical-students/anatomy-of-physis-growth-plate/.

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