What Are Growth Plates?
Growth plates in children sit between the rounded end of the bone (epiphysis) and the long, middle part (diaphysis). This developing tissue made up of cartilage hardens when a child’s bones stop growing and eventually fuses into one complete bone.
Because girls tend to reach skeletal maturity earlier than boys, their growth plates usually close around ages 14 to 15, while boys' growth plates close later, at around ages 16 to 17. However, before growth is complete, the growth plates are susceptible to breaks or fractures. An adult whose bones have finished growing might simply pull a muscle or a tendon after a fall. But in a child, that same fall could not only injure the muscle and tendon, but lead to an injured or fractured growth plate.
Causes of Growth Plate Injuries
Growth plate injuries often occur during contact sports, such as football or basketball, or from activities that require repetitive training, such as gymnastics, track and field or pitching a baseball. An injury or growth plate fracture can also happen during fast-moving activities with a high risk of falling, including skiing, skateboarding, sledding and biking.
Growth plate injuries also can be caused by:
- Contact/collision with other children
- Sudden falls
Growth Plate Injury Symptoms and When to Seek Medical Attention
Signs and symptoms of a growth plate injury include:
- Rapid swelling/deformity
- Severe pain or discomfort
- Inability to move the limb or apply weight/pressure on the limb
Because children heal very quickly, an untreated injury or fractured growth plate can heal improperly, causing the bone involved to end up shorter or abnormally shaped. It is extremely important to seek medical attention in a timely manner if you suspect your child has an injury.
Diagnosing a Growth Plate Injury
Because growth plates are cartilage tissue, X-ray images can be challenging to interpret and a Pediatric Orthopedic Specialist may be consulted.
Based on X-ray results, the physician will often diagnose a growth plate injury in one of five categories:
- Type 1: Injury does not cause the bone on either side to move out of place.
- Type 2: Injury breaks through the growth plate and the metaphysis.
- Type 3: Injury breaks through the growth plate and the epiphysis, the tail end of the bone.
- Type 4: Injury fractures through the growth plate, the metaphysis and the epiphysis.
- Type 5: Injury is a crush or compression growth plate fracture.
Treatment for growth plate injuries initially involves resting and immobilization of the affected limb through the use of a cast, splint or brace to prevent movement. For minor growth plate injuries, this may be the only treatment necessary.
For a more serious injury to growth plate fracture, the bones may be displaced. In this case, a Pediatric Orthopedic specialist may have to manipulate or set the bone back in place through a procedure called a reduction. The child is typically placed in a cast for a few weeks to ensure that the bones do not move out of place.
In children older than 13 or young children with complicated growth plate injuries, surgery may be needed to realign the bones and fix the growth plate. Surgical plates, screws or wires secure the area so that the bone continues to grow normally. After surgery, some children may need to wear a cast throughout the duration of his or her recovery.
After an injury or fracture of the growth plate has healed, some children might need physical therapy to help strengthen the area around the injury, restore normal movement if a joint was affected and ensure joints are functioning normally.
Most kids who are treated for growth plate injuries do not have any long-term complications. However, frequent follow-up at the Pediatric Orthopedic Specialist’s office (for up to a year or longer) is important to ensure bones are healing and continuing to grow normally.
If you suspect your child has suffered an injury or growth plate fracture, please do not hesitate to contact our physicians to schedule an appointment.