Rounds is your vehicle for sharing your orthopaedic
skills and experience. Your response to Rounds will be published in
a future issue of Body Cast. We invite you to suggest questions for
this column. Please address all submissions to: The Editor, Body Cast,
18 Wynford Drive, Suite 715A, North York, Ontario, M3C 3S2.
Issue's Rounds Question - " Tell us about
Concavity compression " (responses
to be published in next issue)
In the last issue of Body Cast, Rounds asked:
is the Harris Growth Arrest Line?”
The following responses were received:
From Edward Clancey:
bones exhibit transversely oriented, dense trabecular bone patterns
within the metaphysic. These usually duplicate the contiguous
physeal contour. They may appear after trauma, particularly when
the child has been immobilized in bed (traction for femoral fracture),
and also may appear after generalized illness or even localized
processes within the bone (e.g., osteomyelitis). The lines result
from a temporary slowdown of normal longitudinal growth rates during
the injury period or illness, and often are referred to as Harris
growth slowdown, the trabeculae of the primary spongiosa become
more transversely than longitudinally oriented, creating temporary
thickening in the primary spongiosa adjacent to the physis. Once
the normal longitudinal growth rate resumes, longitudinal trabecular
orientation is restored. The thickened transverse osseous plate
is “left behind” to be gradually remodelled as primary
spongiosa becomes secondary spongiosa.
From Jean Hohs:
lines, parallel to the growth plates of long bones, seen on radiographs,
represent temporary slowing or cessation of longitudinal growth.
These lines are also known as stress lines, transverse lines,
or Park lines. Some feel “growth recovery lines” are
a more accurate name as they appear to be formed during periods
of renewed growth following a period of growth arrest.
These lines are associated with periods of childhood stress,
infection, trauma or dietary restriction.
From Lori MacDonald and Blair Matheson:
Named after Henry Harris, Welsh anatomist, Harris growth arrest
lines are dense trabecular transversely oriented lines with the
metaphysic, commonly seen in children of all ages. These lines,
also called recovery lines, follow a period of illness or immobilization.
These lines relate to a temporary slowdown of a longitudinal growth.
These lines are usually symmetrical and are most prominent in rapidly
growing metaphyses, e.g. distal femur and proximal tibia. With
further growth, they become incorporated into the diaphysis and
disappear with endosteal remodelling. Analysis of these lines on
radiographs may be useful to corroborate overgrowth of the affected
limb post fracture. A line that converges towards the physis suggests
localized growth damage and may predict the development of a physeal
bar and deformity.
From Cheryl Rivers:
A Harris growth arrest line pertains to children/teens in whom
the bone lines show retarded growth, usually due to trauma to a
bone. According to Blaukett-Nelson, a Harris line is a straight,
thin radiodense line across the metaphysic of bone resulting from
a previous change in the growth rate of that bone, most commonly
seen after a fracture, also called a growth arrest line.
Responses were also received from Livain Arseneau, Lynn Arseneau,
Bernie Arseneault, Tony Bellon, Tom Broughton, Lhea Burk, Eric Christiansen,
Adrian Crossman, Paul Gaudet, Richard Grenier, Suzanne Groulx, Edd
Hayes, Leo Helfer, Roger Ip Fung Chun, Mary Anne Lash, Brian Lavallee,
Cam Longphee, Jacques Mayer, GaryMarshall, Joe Mauluccie, Mary Perkins,
James Punwassie, Vital Robichaud, Elizabeth Seguin, bert Sheppard,
Mark Unger, Angela Wentzell, Joan Wilson, Healther Wong, Neuville
Yao, Tom Yorke and Mary Young.