Injury to the epiphyseal area refers to injury to the epiphysis and epiphyseal growth plate at both ends of the long bones. The growth of bone length is the result of the proliferation of the epiphyseal plate, and if the epiphyseal plate is injured it will affect the growth and development of the bone. Therefore, it is important that epiphyseal injuries are properly diagnosed and treated. Most epiphyseal injuries occur in children and adolescents and are associated with a high level of activity. These injuries account for about 10% of long bone fractures in children. The stability of the joint is maintained by the muscles, ligaments and joint capsule, and the strength of the epiphyseal plate is several times less than the strength of the tendons and ligaments. Therefore, the possibility of injury to the epiphysis is the first consideration in children with joint injuries. In addition to the clinical signs of fracture, an x-ray can reveal epiphyseal injury. Injury to the epiphysis or insufficient blood supply from vascular injury can affect the normal growth and development of the epiphysis or cause the epiphysis to heal early and the bone can no longer elongate. If one side of the epiphysis is injured and the epiphysis fuses, the side will not grow, while the other side continues to grow, the limb will be turned outward or inward, so that the bone will be deformed or shortened, and the two limbs will be of different lengths, and the joint activities will be affected, causing inconvenience to work and study. Theoretically, if the Kirschner needle runs longitudinally through the epiphyseal plate instead of horizontally, the impact on the layers of the epiphyseal plate is not great and generally does not produce deformity or shortening, but I think there are two things wrong with horizontal penetration, one of which is that the mast cell layer is poorly resistant to shear, and the horizontal penetration of several needles can easily lead to epiphyseal separation, but of course no one does this clinically, and I have done this with animal epiphyseal plates; in addition, the horizontal penetration obviously has a greater impact on the growth layer and can easily affect epiphyseal development. Of course, as long as it does not go through the epiphyseal plate, horizontal penetration of the epiphysis is still allowed, and even threaded nails can be used, but this operation should still be performed under fluoroscopy. Whether the longitudinal penetration of the epiphyseal plate by a Kirschner needle leads to the formation of a local bone bridge is still lacking in the corresponding basic research, but one thing is clear: 1 trauma is less than that of a threaded nail 2 the impact on the tension of the epiphyseal plate is also small (cartilage membrane release is for this). This issue should be treated differently: the thickness of the needle, whether it is threaded or not. From the point of view of damage alone, the thicker the needle and the more threaded it is, the greater the damage. The more needles are inserted in the same epiphyseal plate plane, the more damage is done. Diagonal insertion into the epiphyseal plate is more damaging than vertical insertion. At present, I have not seen any data on the extent to which epiphysis is affected by the fixation of the Kirschner pin. However, some famous books (e.g. Campbell Orthopaedics), both domestic and foreign, mention this problem and agree: internal fixation should not be fixed to the epiphyseal plate as much or as little as possible. The following is an excerpt from Huang Xiangqi’s “Pediatric Bone and Joint Injuries” on the sequelae of epiphyseal injuries.