Growth plate fractures

Diagnosis

Because growth plates haven't hardened into solid bone, they are difficult to interpret on X-rays. Doctors may ask for X-rays of both the injured limb and the opposite limb so that they can be compared.

Sometimes a growth plate fracture cannot be seen on X-ray. If the child is tender over the area of the growth plate, your doctor may recommend a cast or a splint to protect the limb. X-rays are taken again in three to four weeks and, if there was a fracture, new bone healing will typically be seen at that time.

For more-serious injuries, scans that can visualize soft tissue — such as magnetic resonance imaging (MRI), computerized tomography (CT) or ultrasound — may be ordered.

Treatment

Treatment for growth plate fractures depends on the severity of the fracture. The least serious fractures usually require only a cast or a splint. If the fracture crosses the growth plate or goes into the joint and is not well-aligned, surgery may be necessary. Growth plates that are surgically realigned may have a better chance of recovering and growing again than do growth plates that are left in a poor position.

At the time of injury, it's difficult to tell if a growth plate has permanent damage. Your doctor may recommend checking X-rays for several years after the fracture to make sure the growth plate is growing appropriately. Depending on the location and severity of the fracture, your child may need follow-up visits until his or her bones have finished growing.

Preparing for your appointment

If your child is injured, you may go straight to an emergency room or urgent care clinic. Depending on the severity of the break, the doctor who first examines your child may recommend a consultation with a pediatric orthopedic surgeon.

What you can do

To prepare for your conversation with the doctor, you may want to write a quick list that includes:

• Your child's symptoms
• How the injury occurred
• Your child's key medical information, including any other medical problems and the names of all medications and vitamins he or she takes
• The sports or recreational activities in which your child regularly participates
• Questions you want to ask the doctor

What to expect from your doctor

Your doctor may ask:

• How did the injury happen?
• Where does it hurt?
• How much does it hurt?
• Does anything relieve the pain?
• Was there any pain in the affected area before the injury, such as during sports or recreational activity?
• What concerns do you have about your child's return to sports or play?
• Have there been previous fractures?