Growth plate fractures

Overview

A growth plate fracture affects the layer of growing tissue near the ends of a child's bones. Growth plates are the softest and weakest sections of the skeleton — sometimes even weaker than surrounding ligaments and tendons. An injury that might cause a joint sprain for an adult can cause a growth plate fracture in a child.

Growth plate fractures often need immediate treatment because they can affect how the bone will grow. An improperly treated growth plate fracture could result in a fractured bone ending up more crooked or shorter than its opposite limb. With proper treatment, most growth plate fractures heal without complications.

Symptoms

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

• Pain and tenderness, particularly in response to pressure on the growth plate
• Inability to move the affected area or to put weight or pressure on the limb
• Warmth and swelling at the end of a bone, near a joint

When to see a doctor

If you suspect a fracture, take your child to be examined by a doctor. Also have your child evaluated if you notice a visible deformity in your child's arms or legs, or if your child is having trouble playing sports because of persistent pain.

Causes

Growth plate fractures often are caused by a fall or a blow to the limb, as might occur in:

• A car accident
• Competitive sports, such as football, basketball, running, dancing or gymnastics
• Recreational activities, such as biking, sledding, skiing or skateboarding

Growth plate fractures can occasionally be caused by overuse, which can occur during sports training or repetitive throwing.

Risk factors

Growth plate fractures occur twice as often in boys as in girls, because girls finish growing earlier than do boys. By the age of 12, most girls' growth plates have already matured and been replaced with solid bone.

Complications

Most growth plate fractures heal with no complications. But the following factors can increase the risk of crooked, accelerated or stunted bone growth.

• Severity of the injury. If the growth plate has been shifted, shattered or crushed, the risk of limb deformity is greater.
• Age of the child. Younger children have more years of growth ahead of them, so if the growth plate is permanently damaged, there is more chance of deformity developing. If a child is almost done growing, permanent damage to the growth plate may cause only minimal deformity.
• Location of the injury. The growth plates around the knee are more sensitive to injury. A growth plate fracture at the knee can cause the leg to be shorter, longer or crooked if the growth plate has permanent damage. Growth plate injuries around the wrist and shoulder usually heal without problems.