The bones of children and adults share many of the same risks for injury. However, a child’s bones are also subject to a unique injury called growth plate fractures.
Growth plates are areas of developing cartilage tissue near the ends of long bones. The growth plate regulates and helps determine the length and shape of the mature bone.
The long bones of the body do not grow from the center outward. Instead, growth occurs at each end of the bone around the growth plate. When a child becomes full-grown, the growth plates harden into solid bone.
Growth plates are located between the widened part of the shaft of the bone (the metaphysis) and the end of the bone (the epiphysis). This diagram of a femur (thighbone) shows the location of the growth plates at both ends of the bone.
Because growth plates are the last portion of bones to harden (ossify), they are vulnerable to fracture. In fact, because muscles and bones develop at different speeds, a child’s bones may be weaker than the ligament tissues that connect the bones to other bones.
Children’s bones heal faster than adult’s bones. This has two important consequences:
A child with an injury should see a doctor as quickly as possible, so the bone gets the proper treatment before it begins to heal. Ideally, this means seeing an orthopaedic specialist within 5 to 7 days of the injury, especially if manipulation to align the bone is required.
The fracture will not need to stay in a cast for as long as an adult fracture would require for healing.
Appropriate evaluation by an orthopaedic surgeon experienced in orthopaedic trauma will determine the nature of the growth plate injury, will provide counseling about treatment options, and will allow for longer term follow up to assess the outcome of the injuries.
Approximately 15% to 30% of all childhood fractures are growth plate fractures. These often require immediate attention because the long-term consequences may include limbs that are crooked or of unequal length.
Although growth plate injuries are common, serious problems are rare. Growth deformity occurs in 1% to 10% of all growth plate injuries.
Most growth plate fractures — more than 30% — occur in the long bones of the fingers. They are also common in the outer bone of the forearm (radius), and lower bones of the leg (the tibia and fibula).