Growth Plate Fractures
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.
Statistics.
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).
Cause
Growth plate fractures can result from a single traumatic event, such as a fall or automobile accident, or from chronic stress and overuse.
Symptoms
Any child who experiences an injury that results in visible deformity, persistent or severe pain, or an inability to move or put pressure on a limb should be examined by a doctor.
Diagnosis
Physical Examination & Patient History
During your first visit, your doctor will talk to you about your symptoms and medical history. During the physical examination, your doctor will check all the structures of your injury, and compare them to your non-injured anatomy. Most injuries can be diagnosed with a thorough physical examination.
Imaging Tests
Imaging Tests Other tests which may help your doctor confirm your diagnosis include:
X-rays. Although they will not show any injury, x-rays can show whether the injury is associated with a broken bone.
Magnetic resonance imaging (MRI) scan. If your injury requires an MRI, this study is utilized to create a better image of soft tissues injuries. However, an MRI may not be required for your particular injury circumstance and will be ordered based on a thorough examination by your Peninsula Bone & Joint Clinic Orthopedic physician.
Principles of Sports Medicine
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Timely Care
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Minimally Invasive Procedures
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Advanced Rehabilitation
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Injury Prevention
One of the main goals of sports medicine is to put off major orthopedic surgery (such as joint replacement) as long as possible or even remove the need altogether with physical therapy, minimally invasive arthroscopic surgery and timely care.
When everything is working well, you hardly give them a thought. But when a problem arises, it’s often impossible to ignore.
Treatment Options
Non-Surgical
Many can be treated with cast immobilization but surgical treatment may be necessary. If surgery is needed, these fractures are often treated with internal fixation (pins) to hold the bone together and ensure proper alignment.
Surgical
Type I Fractures
These fractures may result in disrupted bone growth.
Many can be treated with cast immobilization but surgical treatment may be necessary. If surgery is needed, these fractures are often treated with internal fixation (pins) to hold the bone together and ensure proper alignment.
Type II Fractures
These fractures generally heal well, although surgery may sometimes be required. This is the most common type of growth plate fracture.
Most are treated with cast immobilization.
Type III Fractures
This Type III fracture of the thighbone (femur) goes through the growth plate and down into the knee joint. The fracture is fixed in place with screws. This restores normal joint alignment.
These fractures are more common in older children. Because the center of the growth plate has begun to harden, the fracture does not continue across the bone, but angles down and breaks the bone end.
A Type III fracture is treated with surgery and internal fixation to ensure proper alignment of both the growth plate and the joint surface.
Type IV Fractures
These fractures commonly stop bone growth.
They are treated with surgery and internal fixation.
Type V Fractures
These fractures can often be treated with cast immobilization, or may require surgery.
There is almost always a growth disturbance with these fractures.
Conservative Treatment Options
Treatment Highlights
FastFix 360 – Meniscus Repair
