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Growth Plate Fracture
Growth plates are the softer parts of your child's bones, where growth occurs. Located at each end of a bone, growth plates are the weakest sections of the skeleton - even weaker than the surrounding ligaments and tendons. Because growth plates are so fragile, an injury that would result in a joint sprain for an adult can cause a fracture in your child.
Growth plate fractures often need immediate treatment because they can affect how the bone will grow. The fractured bone could end up being crooked, or shorter than its opposite limb. With proper treatment, however, most growth plate fractures heal without complications.
Signs and symptomsHalf of all growth plate injuries occur in the forearm bone, at the wrist. The lower leg bones are also particularly susceptible to these types of injuries. Growth plate fractures can also occur in the ankle, foot or hip.
If you suspect a fracture - particularly if there is pain that interferes with moving or putting pressure on a limb - your child should be examined by a doctor.
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Causes
Most growth plate fractures are caused by a fall or a blow to the limb. Injuries also can be caused by overuse, which can occur during sports training. Obesity also leads to overuse-related growth plate fractures, particularly in the growth plates of the hips.
A third of all growth plate injuries occur in competitive sports, such as football, basketball or gymnastics. Another 20 percent happen during recreational activities, such as biking, sledding, skiing or skateboarding.
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Risk Factors
Fifteen percent of all childhood fractures involve a growth plate. Growth plate fractures occur twice as often in boys as in girls, with the greatest incidence among boys ages 14 to 16 and girls ages 11 to 13. Older girls experience these fractures less often because their growth plates have already matured and been replaced with solid bone.
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Screening and diagnosis
Because growth plates haven't hardened into solid bone, they are difficult to interpret on X-rays. Sometimes, doctors ask for X-rays of both the injured limb and the opposite limb so they can be compared. In some cases, scans that can visualize soft tissue - such as magnetic resonance imaging (MRI), computerized tomography (CT) or ultrasound - may be ordered.
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Treatment
Treatment for growth plate fractures depends on the severity of the fracture. The least serious fractures usually require only a cast or a splint. Injuries in which a part of the bone end has separated from the bone shaft typically will need surgical repair.
If your child has had a growth plate fracture, your doctor probably will want to compare the growth of the injured limb with that of its opposite limb every three to six months for at least two years. Some fractures must be followed until the child's bones have finished growing.
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Complications
Around 85 percent of growth plate fractures heal with no complications. The following factors can increase the risk for twisted or stunted bone growth.
- Severity of the injury. If the growth plate has been shifted, shattered or crushed, the risk of limb deformity is greater. Reduced blood supply to the tip of the bone also increases this risk.
- Age of the child. Younger children have more years of growth ahead of them, so they are at risk of abnormalities for a longer period of time.
- Location of the injury. Some growth plates grow more than others. Risk increases with injuries to the growth plates that grow the most - for example, the ones around the knee.
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