Growth Plate Fractures
Growth plates are the areas of active, new bone growth near the ends of the long bones. They're made up of cartilage, a rubbery, flexible material (the nose, for instance, is made of cartilage). Growth plates allow room for the bones to grow as kids grow. As teens reach their full growth, the growth plates harden into bones. In girls, this typically happens between 13-15 years of age. In boys, it usually occurs between 15-17 years of age.
When a growth plate is injured, it's important to see a pediatric orthopedist to ensure that the fracture heals properly to prevent problems later.
Growth plate fractures are when there is a break in the growth plate. This happens most often in the bones of the fingers, forearm, and lower leg. Most growth plate fractures heal and do not affect future bone growth.
Sometimes, changes in the growth plate from the fracture can cause problems later. For example, the bone could end up a little crooked or a bit longer or shorter than expected.
Most growth plate fractures happen from falling or twisting. Contact sports (like football or basketball) or fast-moving activities (like skiing, skateboarding, sledding, or biking) are common causes. Growth plate fractures also can happen from repetitive activities, like training for gymnastics or pitching a baseball.
A child with a growth plate fracture can have pain, swelling, and trouble moving and using the injured body part. Sometimes there is a deformity — this means that the body part looks crooked or different than it did before the injury.
In most cases, your child have an X-rays to determine if a bone is broken. Some mild growth plate fractures don't show up on an X-ray, though. In this situation, other imaging tests may be needed.
But if bones are out of place (or displaced), they have to be put back into the right position with a procedure called a reduction. A reduction is also called setting the bone. There are two types of reductions:
- A closed reduction is done in the emergency room or operating room, after the child has been given medicine to ease the pain. The surgeon gently moves the bones back into the right position. No incision (cut) is needed.
- An open reduction is a surgery done for a more complicated injury. It is done in the operating room under general anesthesia. The surgeon makes an incision and moves the bones into the right position. Surgical plates, screws, or wires often are used to keep the bones in place.
After an open or closed reduction, the child will usually wear a cast, splint, or brace to make sure the bones don't move during healing.
Most kids recover from growth plate fractures without any long-term problems.
However, sometimes changes in the growth plate from the fracture can cause problems later. For example, the bone could end up a little crooked or slightly longer or shorter than expected. If the bone does not grow normally, surgery or other treatments may be needed.
Ensuring your child follows the doctor’s directions can help prevent future. Be sure to go to all follow-up doctor visits to make sure the bones heal well and continue to grow normally.