Growth Plate Fractures: Causes, Symptoms, Diagnosis and Treatment

The growth plate fracture affects the layers of tissue near the ends of the child’s bones. Growth plates are the softest and weakest sections of the skeleton. Sometimes they are even weaker than the surrounding ligaments and tendons. An injury that could cause a joint sprain in an adult can cause a growth plate fracture in a child.

Growth plate fractures often require immediate treatment because they can affect bone growth. A poorly treated growth plate fracture can result in a fractured bone that is more twisted or shorter than its opposite limb. With proper treatment, most growth plate fractures heal without complications.

Most growth plate fractures occur in the bones of the fingers, forearms, and lower legs. Signs and symptoms of a growth plate fracture may include the following:

Pain with or without palpation, especially in response to pressure on the growth plate Inability to move the affected area, or to put weight or pressure on the extremity Heat and swelling at the end of a bone near a joint

If you suspect your child has a broken bone, take him to a doctor for a checkup. They should also be checked if you notice any visible deformity in the arms or legs, or if the child has difficulty playing sports due to persistent pain.

Growth plate fracture is more common in boys than in girls (twice as many cases), because girls finish growing before boys. By age 12, most growth plates in girls have matured naturally and been replaced by solid bone.

Because the growth plates have not consolidated into solid bone, they are difficult to examine with x-rays. Doctors may order x-rays of injured and opposing limbs for comparison.

Sometimes a growth plate fracture cannot be seen with X-rays. If the child feels tender at the site of the growth plate, the doctor may recommend a cast or splint to protect the limb. X-rays are taken again in three to four weeks and if there has been a fracture, the newly recovered bone can usually be seen at this time.

For more severe injuries, tests to visualize soft tissue, such as magnetic resonance imaging (MRI), computed tomography (CT), or ultrasound, may be indicated.

Treatment for growth plate fractures depends on the severity of the fracture. Less severe fractures usually only require a cast or splint. If the fracture crosses the growth plate or extends into the joint and is out of alignment, surgery may be required. The growth plates may have a better chance of recovering and growing back if the patient undergoes realignment surgery, as opposed to what happens if the growth plates are left in the wrong position.

At the time of injury, it is difficult to determine if the growth plate has been permanently damaged. Your doctor may recommend taking x-rays for several years after the fracture to make sure the growth plate is developing properly. Depending on the location and severity of the fracture, the child may need follow-up visits until the bones have finished developing.