Growth Plate Injuries
What Are Growth Plates?
Growth plates are located on the long bones of children and young people. These plates are areas of growing tissue near the end of the bones.
Each long bone has at least two growth plates-one at each end. This is where the long bones grow. When young people finish growing, the growth plates close and are replaced by solid bone.
Growth plate injuries occur mainly at the wrist, bones of the legs, or in the ankle, foot, or hip bones.
Who Gets Growth Plate Injuries?
Growth plate injuries happen to children and young people. The growth plate is the weakest part of the growing skeleton. Injuries to the plates are called fractures.
Growth plate fractures happen twice as often in boys as in girls. And, fractures are most likely in 14- to 16-year-old boys and 11- to 13-year-old girls.
What Causes Growth Plate Injuries?
Growth plate injuries happen for many reasons. Most occur after a sudden accident, such as falling or being hit hard on the leg. People who sometimes get injuries from overuse include:
- Gymnasts who practices for hours on the uneven bars
- Long-distance runners
- Baseball pitchers perfecting their curve balls.
The top reasons for growth plate injuries are:
- Falling down
- Competitive sports (like football)
- Recreational activities
- Car, motorcycle, and all-terrain-vehicle accidents (only in a small number of cases).
Other reasons for growth plate injuries are:
- Child abuse
- Injury from extreme cold (for example, frostbite)
- Radiation (used to treat certain cancers)
- Neurological disorders that cause people to lose their balance and fall
- Some inherited disorders
- Bone infections.
When to See a Doctor
A child should never have to "work through the pain." Parents should take their child to see a doctor when:
- The child has to stop playing because of pain after a sudden injury.
- The child is less able to play because of an old injury.
- The child's arm or leg bends the wrong way.
- The child cannot move an arm or leg because of pain.
- The pain continues after overuse or injury.
How Are Growth Plate Fractures Diagnosed?
First, the doctor will find out how the injury happened. Second, the doctor will examine the child and use x rays to find out what kind of fracture it is. Third, a treatment plan is chosen.
Sometimes other tests are used to look at the fracture, including CT scan (a special x ray), and ultrasound (uses sound waves to look inside the body).
What Kind of Doctor Treats Growth Plate Injuries?
An orthopaedic surgeon (a doctor who treats bone and joint problems) treats most growth plate injuries. At other times, the child will see a paediatric orthopaedic surgeon (a doctor who treats bone and joint problems in children).
How Are Growth Plate Injuries Treated?
The treatment depends on the type of fracture. However, with all fractures, treatment should start as soon as possible. Treatment usually involves a mix of the following:
- Immobilisation (a cast or splint)
- Manipulation or surgery (depending on where and how serious the injury is, and the patient's age)
- Exercises (only after the fracture heals)
- Long-term followup (including x rays).
How Well Do Children Grow After a Growth Plate Injury?
Most growth plate fractures get better and do not cause any lasting problems. Occasionally, the bone stops growing and ends up shorter than the other limb. For example, a fractured leg might end up shorter than the other leg. Or, if only part of the growth plate is injured, the limb can become crooked when only part of the bone keeps growing.
Lasting problems are most common with injuries to the knee.
