Revista de Medicina Desportiva (English) July 2018 - Page 25

growth of the affected member all can happen . Hence the council to immediately alert the parents to this possibility .
Dra . Joana Santos Costa . Resident physician of Physical Rehabilitation Medicine . Coimbra
Physiological peculiarities and the immature skeleton
“ Children are not Adults Miniature . “ There are significant differences in the anatomy and physiology of the skeleton and multiple alterations inherent to bone growth and maturation , which also translate into differences in the way the skeleton responds to the lesion . The bones have greater elasticity , which means that in response to a compressive force the bone can be deformed without fracturing ( plastic deformation ) or present an incomplete fracture in the apex of the deformation curve ( Buckle fracture ), which are rare lesion patterns in adults . Also , the porosity is increased in the immature bone , causing less fracture
spread and low incidence of comminuted fractures . The periosteum , in turn , is thicker and more resistant , which increases the stability of the skeleton , but it confers less capacity to withstand angular deformation . As it is more easily separated from the bone , cortical lesions may even occur with integrity of the periosteum . The physis and the metaphysis are joined internally by the mamilla processes and externally by the periosteum , both with high resistance . This type of union permits the existence of microscopic translational forces and confers relative flexibility . However , since ligaments are more resilient than bone , external forces that typically cause sprains / dislocations in adults often cause lesions of the growth plate in the child , and ligament lesions are rare isolated before the age of 14 . In some bones , the physis can grow up to five times faster than the adjacent articular cartilage , which can be translated into greater accentuation of the varus and valgus deviations . In children , the high metabolism , the fast bone remodeling , wider Havers canals and the high osteogenic potential
of periosteum , guarantee a great capacity of pós-lesional regeneration and rapid bone consolidation . Physical activity promotes beneficial adjustments in the skeleton , without changing the process of maturation or growth . In particular , the pre-pubertal period is a phase of great ostheotrofic potential , with the effect of maximizing the peak of bone mass . However , during the phase of linear growth , the imbalance between strength and flexibility and the biomechanical alterations of the bone , with a progressive increase in rigidity and the decrease on the resistance of impact , predisposes to overload lesions . Especially at this stage , sports injuries that afflicts the growth plate may result on limbs dysmetria , permanent angular deformities , and changes on joint biomechanics , that will cause long-term disability . It is therefore important for any physical-recreational or sports activity to integrate all these pathophysiological concepts and to respect the maturation status of the child and adolescent in order not to compromise their bone development and their physical and sports future .
TECNOLOGIA
DE ADAPTAÇÃO ATIVA
DESIGN LIGEIRO E DISCRETO
ADAPTAÇÃO ANATÓMICA
DESIGN ERGONÓMICO
PLACA ALUMINIO / Dorsotech ®
Revista de Medicina Desportiva informa july 2018 · 23 www . interorto . pt
growth of the affected member all can happen. Hence the council to immediately alert the parents to this possibility. Dra. Joana Santos Costa. Resident physician of Physical Rehabilitation Medicine. Coimbra Physiological peculiarities and the immature skeleton “Children are not Adults Miniature. “ There are significant differences in the anatomy and physiology of the skeleton and multiple alterations inherent to bone growth and matu- ration, which also translate into differences in the way the skeleton responds to the lesion. The bones have greater elasticity, which means that in response to a compressive force the bone can be deformed without fracturing (plastic deforma- tion) or present an incomplete frac- ture in the apex of the deformation curve (Buckle fracture), which are rare lesion patterns in adults. Also, the porosity is increased in the imma- ture bone, causing less fracture spread and low incidence of commi- nuted fractures. The periosteum, in turn, is thicker and more resistant, which increases the stability of the skeleton, but it confers less capac- ity to withstand angular deforma- tion. As it is more easily separated from the bone, cortical lesions may even occur with integrity of the periosteum. The physis and the metaphysis are joined internally by the mamilla processes and exter- nally by the periosteum, both with high resistance. This type of union permits the existence of microscopic translational forces and confers relative flexibility. However, since ligaments are more resil Y[[ۙK^\[ܘ\]\X[B]\HZ[\][ۜ[Y[›ٝ[]\H\[ۜوHܛ]H[H[ [Y[Y[\[ۜ\H\H\]YYܙHBYHو M [YHۙ\H\\˜[ܛ\]H[Y\\\[HYX[\X[\\KBYKX[H[]Y[™ܙX]\X[X][ۈوH\\˜[[\]X][ۜˈ[[[HYY]X\KH\ۙB[[[[Y\]\[[˜[HY[[X[X[و\[][KX\[YHHܙX]\X]Hو0[\[ۘ[Y[\KB[ۈ[\YۙHۜY][ۋ\X[X]]H[\[YKBX[Y\Y[[H[]ۋ]][[H\قX]\][ۈ܈ܛ [\X[\HK\X\[\[\H\BوܙX][ٚX[X[ ]HYXوX^[Z^[HXZ›وۙHX\ˈ]\\[B\Hو[X\ܛ H[X[ B[H]Y[[[^X[ B]H[H[YX[X[[\KB[ۜوHۙK]Hܙ\]B[ܙX\H[YY]H[HXܙX\BۈH\\[Hو[\X Y\B\ݙ\Y\[ۜˈ\XX[B]\YKܝ[\Y\]YXHܛ]HX^H\[ۈ[X\Y]XK\X[[[[\YܛZ]Y\[[\ۂ[[YX[X][]\Bۙ]\H\X[]K]\\YܙB[\ܝ[܈[H\X[ \XܙXKB[ۘ[܈ܝX]]H[Yܘ]B[\H]\[X[ۋB\[\XHX]\][ۂ]\وH[[Y\[[ܙ\\Z\HZ\ۙB][Y[[Z\\X[[ܝ]\KPӓPHBQTpUUBTQӈQRT‘HTԑUQTpSU0RPBTQӂTӰRP”PHSSRSS ܜX0]\HHYYX[H\ܝ]H[ܛXH[H N0 ˚[\ܝ˜