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Why does the osteomyelitis infection begin in metaphysis in children?

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In infants, there are anastomoses between metaphyseal and epiphyseal blood vesels. But, in children of more than 1 year of age the metaphysial branches of the nutrient artery do not penetrate the growth plate. The non-anastomosing terminal branches of the nutrient artery twist back in hairpin loops before entering the large network of sinusoidal veins. The venous sinusoids are much larger than the arteries feeding them, have a slower blood flow, and lower oxygen tension which favor bacterial colonization.

answered Jun 20, 2013 by Sulabh Shrestha Doctor of Medicine (5,553 points)
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