Growth Plate Fractures

Children's bones have special areas called growth plates near their ends. These plates are areas of growing tissue that help bones lengthen and shape. They're the softest and most vulnerable parts of a child's skeleton. Sometimes, they're even weaker than the ligaments and tendons that connect and support the bones.

If a child breaks a bone and the break goes through a growth plate, it can cause problems with how the bone grows. This is because the growth plate is essential for the bone's lengthening and shaping. A minor injury that might just sprain an adult's joint could cause a growth plate fracture in a child.

Because growth plates are so important for bone development, a fracture that affects one needs prompt medical attention. If a growth plate fracture isn't treated correctly, the affected bone might grow crooked or shorter than the other bone in the same limb. Fortunately, most growth plate fractures heal well with proper care and attention from a doctor.

Growth plate fractures most often happen in the bones of the fingers, forearm, and lower leg. These fractures can cause several noticeable problems.

Signs of a growth plate fracture might include:

• Pain and soreness: This pain is often especially bad when you press on the area near the growth plate.
• Limited movement: Your child might not be able to use the affected area normally. They might also be unable to put weight on the injured limb.
• Warmth and swelling: You might notice the area around the end of the bone, near a joint, feels warm and swollen.

If you think your child might have a growth plate fracture, it's crucial to take them to a doctor for a check-up right away. Also, see a doctor if you notice:

• A change in shape: If you see an unusual bend or curve in your child's arm or leg.
• Problems with activity: If your child is having trouble participating in sports or other physical activities due to ongoing pain.

Early diagnosis and treatment are important for a speedy recovery.

Growth plate fractures happen when a fall or impact damages the part of a bone that helps a child grow taller. This can happen in various situations:

• Accidents: A car crash, for example, can cause a growth plate fracture.
• Sports: Injuries can occur during competitive sports like football, basketball, running, dancing, and gymnastics. Even recreational activities like biking, sledding, skiing, or skateboarding can lead to these injuries. The impact of a fall or collision can directly hurt the growth plate.
• Overuse: Sometimes, repetitive motions, like those in intense sports training or repeated throwing, can weaken the growth plate over time. This gradual wear and tear can eventually result in a fracture. Think of it like repeatedly bending a wire – eventually, it breaks.

In short, growth plate fractures are often caused by either a sudden, forceful impact or by the gradual, repetitive stress of overuse.

Boys are more likely to experience growth plate fractures than girls. This is because girls typically stop growing taller sooner than boys. By the time girls reach 12 years old, their growth plates, which are areas of developing bone, have usually hardened and turned into solid bone. Boys, on the other hand, are still growing and their growth plates are more vulnerable.

Growth plate fractures often heal without problems. However, several things can make it more likely that the healing process will cause the bone to grow crooked, too fast, or too slow.

• How bad the break is: If the growth plate is significantly moved out of place, broken into pieces, or crushed, there's a higher chance the bone may not grow straight. This is because the damaged growth plate may not work correctly.

• How old the child is: Younger children have more time for their bones to grow. If the growth plate is permanently harmed, there's a greater chance of a noticeable problem with the way the limb grows. If a child is close to finishing growing, a damaged growth plate might only cause a small problem.

• Where the break is: Growth plates near the knee are more delicate and vulnerable. If a growth plate fracture occurs near the knee, and the growth plate is permanently damaged, this can lead to the leg being shorter, longer, or misshapen. Growth plate injuries in the wrist or shoulder are usually less likely to cause long-term problems.

Essentially, the severity of the break, the child's age, and the location of the break all affect the potential for problems with the final bone shape and growth.

Children's bones have special areas called growth plates that haven't fully hardened yet. This makes them hard to see clearly on standard X-rays. To get a better picture, doctors often compare X-rays of the injured limb with an X-ray of the healthy limb on the opposite side of the body.

Sometimes, even with a comparison, a growth plate fracture isn't visible on an X-ray. If a child is experiencing pain or tenderness in the area of the growth plate, the doctor might put a protective cast or splint on the limb. This helps to keep the injured area still while it heals. Another X-ray is taken after about three to four weeks. If there was a fracture, new bone growth will usually be visible in the follow-up X-ray.

For more severe injuries, doctors may order other types of scans that can see details of soft tissues. These special scans, like MRIs (magnetic resonance imaging), CT scans (computed tomography), or ultrasounds, can give a more detailed view of the injury and how the growth plate is affected.