[Long-term follow-up of stress injuries to the metaphyses and apophyses of the spinous processes of juvenile thoracic spines (Schmitt's disease) (author's transl)].

Unlike the clay-shoveller's fracture in adults, stress injuries in juveniles trend to be localised at the tip of the spinous process, i.e. in the metaphysis, the apophyseal line and the apophysis. Characteristic changes are found only between 14 1/2 and 16 1/2 years, at, or immediately before, ossification of the tip of the apophysis. These fractures share with the corresponding fractures in adults similar occupational history, a similar clinical picture with a benign course of the disease. Healing is by the formation of a pseudo-arthrosis which may, however, consolidate after several months or years. Synonyms which have been used for the stress injury to the spinous process in the growing skeleton are: clay-shoveller's fractures in juveniles, apophysitis of the spinous process, aseptic necrosis of the spinous process, gross disturbance of the spinous process after chronic trauma or Schmitt's disease.