Orthonotes
Orthonotes
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Epiphyseal Growth Plate — Zones & Regulation

Zones: reserve (resting), proliferative, hypertrophic (maturation, degeneration, provisional calcification). Regulation: Ihh/PTHrP feedback loop, GH/IGF‑1 axis, local factors (TGF‑β, BMPs, FGFs, Wnt). Hypertrophic zone is weakest → site of Salter‑Harris fractures. Vascular invasion and endochondral ossification occur at metaphyseal side. Clinical: growth arrest, bar formation, angular deformity after physeal injury; SCFE affects hypertrophic zone. Imaging: physeal widening (rickets), metaphyseal...