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Injuries to the physis by extravasation. A rare cause of growth plate arrest

I Sanpera1, J A Fixsen, R A Hill

  • 1Hospitals for Sick Children, London, England.

Insights

Infants may develop ankle deformities from intravenous infusion extravasation damaging the growth plate (physis). This report discusses injury mechanisms to the physis in these cases.

Area of Science:

  • Orthopedics
  • Pediatric Medicine
  • Radiology

Background:

  • Intravenous (IV) infusions are common in neonates and infants.
  • Extravasation of IV fluids can lead to local tissue damage.
  • The pediatric physis (growth plate) is vulnerable to injury.

Observation:

  • Two cases are presented where ankle deformity developed in infancy.
  • The deformity was secondary to physeal damage.
  • The physeal damage resulted from extravasation of an intravenous infusion.

Findings:

  • Extravasation injury to the infant physis can cause significant bone deformity.
  • Specific patterns of physeal damage may correlate with the type and location of extravasated fluid.
  • Mechanisms include direct chemical injury, ischemia, and inflammatory responses.

Implications:

  • Early recognition of extravasation is crucial to prevent long-term skeletal deformities.
  • Understanding injury mechanisms can guide management and treatment strategies.
  • This highlights the importance of careful IV site monitoring in pediatric patients.

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