Apophysen – die Achillesferse junger Sportler

Abstract

Apophyses are bone nuclei of adolescence that are connected to the actual bone via their cartilaginous apophyseal joint. They are of particular clinical relevance where larger tendons and ligaments attach. The apophyses, as well as their joints, are particularly active during growth and represent potentially injury-prone areas, especially in developing young athletes during critical phases of growth. Repetitive tension stress can lead to inflammatory irritations of the apophyses, i.e. apophysitis. Depending on age and sex, the apophysitia is typical in different locations. Areas such as the heel (Sever’s disease) or the knee (M. Osgood-Schlatter or M. Sinding-Larsen-Johansson) are particularly proned. Avulsion fractures occur when the pulling force on a tendon exceeds the strength of the apophysis, resulting in an avulsion of a bone fragment. By far the most common type of this injury occurs in the pelvic region, but in principle it can take place in any apophysis. Understanding the development of apophyses and recognising the diseases or injuries associated with them is essential for effective and sustainable treatment.