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After Trauma: Growth Plate Fractures

Growth plates, also known as epiphyseal plate or physis, are the area of growing tissue near the end of the long bones in children and adolescents. Located at each end of a bone, growth plates are the weakest sections of the skeleton — sometimes even weaker than surrounding ligaments and tendons. Because growth plates are so fragile, growth plate or epiphyseal plate injury that would result in a joint sprain for an adult can cause a growth plate fracture in your child.
Growth plate fractures often need immediate treatment because they can affect how the bone will grow. An improperly treated growth plate fracture could result in a fractured bone ending up more crooked or shorter than its opposite limb (leg shortening). But the comforting news for your child is that with proper treatment, most growth plate fractures heal without complications.

Who Gets Growth Plate Injuries?

These injuries occur in children and adolescents. The growth plate is the weakest area of the growing skeleton, weaker than the nearby ligaments and tendons that connect bones to other bones and muscles. In a growing child, a serious injury to a joint is more likely to damage a growth plate than the ligaments that stabilize the joint. An injury that would cause a sprain in an adult can be associated with a growth plate injury in a child.
Injuries to the growth plate are fractures. They comprise 15 percent of all childhood fractures. They occur twice as often in boys as in girls, with the greatest incidence among 14- to 16-year-old boys and 11- to 13-year-old girls. Older girls experience these fractures less often because their bodies mature at an earlier age than boys. As a result, their bones finish growing sooner, and their growth plates are replaced by stronger, solid bone.
Approximately half of all growth plate injuries occur in the lower end of the outer bone of the forearm (radius) at the wrist. These injuries also occur frequently in the lower bones of the leg (tibia and fibula). They can also occur in the upper leg bone (femur) or in the ankle, foot, or hip bone.

Symptoms of Fractured Growth Plates

Most growth plate fractures occur in bones of the fingers, forearms, at the wrist and/or lower leg. Signs and symptoms of a growth plate injury may include:

  • Severe pain that doesn't go away
  • An inability to move the affected area
  • An inability to put weight or pressure on the area

Causes of Fractured Growth Plate

About 15 percent of all childhood fractures involve a growth plate. Growth plate fractures often are caused by a fall or a blow to the limb, as might occur in:

  • A car accident which might cause leg or limb deformities
  • Competitive sports, such as football, basketball, running, dancing or gymnastics
  • Recreational activities, such as biking, sledding, skiing or skateboarding
  • Broken growth plate can also be caused by overuse, which can occur during sports training.

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 may 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. Depending on the severity of the fracture, your child may need follow-up visits until his or her bones have finished growing.

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