Overview on growth plate fractures

Bones of children and adults share the same risk for injuries. On the other hand, since children are still growing, their bones are subject to growth plate fractures. The growth plates are areas of cartilage that are situated close to the ends of the bones. Since they are the last part of the bones to harden, they are prone to fractures.

Most cases of fractures that occur among children are growth plate fractures. Since the growth plate helps determine the future length and shape of the mature bone, this type of fracture entails prompt attention. If not treated properly, it can lead to a crooked limb or unequal length when compared to the unaffected limb. Luckily, the serious issues are uncommon. With correct treatment, most cases of growth plate fractures can heal without any complications. To learn to recognize and manage bone injuries, register for first aid training here.

What are growth plate fractures?

Most cases of growth plate fractures involve the long bones of the fingers. They can also occur in the exterior bone of the forearm as well as lower bones of the leg.

Growth plate fracture
Most cases of growth plate fractures involve the long bones of the fingers. They can also occur in the exterior bone of the forearm as well as lower bones of the leg.

Classification of growth plate fractures

The commonly used system in categorizing the types of growth plate fractures is the Salter-Harris system.

  • Type I fractures involves a break through the bone at the growth plate which separates the bone end from the shaft and entirely disrupting the growth plate.
  • Type II fractures involves a break through part of the bone at the growth plate and crack via the bone shaft. This is considered as the most common type of growth plate fracture.
  • Type III fractures crosses through a part of the growth plate and break off a piece of the bone end. This typically occurs among older children.
  • Type IV fractures involves a break through the bone shaft, growth plate and end of the bone.
  • Type V fractures occur due to a crushing injury to the plate from a compressive force but rarely occur.

Possible causes

Growth plate fractures can be caused by a single event such as vehicular accident or fall. It can also occur due to repetitive stress on the bone especially when overtraining in certain sports.

Remember that all children who are still growing face the risk for growth plate injuries, but certain factors can increase the risk.

  • Fractures can occur twice as often in boys than girls since girls finish growing earlier than boys
  • Fractures can occur during participation in competitive sports
  • Incidence of fractures increases during adolescence
  • Can occur while participating in recreational activities such as skiing, biking or sledding

What are the symptoms?

A growth plate fracture typically causes severe or persistent pain and can be accompanied by other symptoms such as the following:

  • Visible deformity such as the twisted appearance of the limb
  • Swelling, tenderness and warmth in the area around the end of the bone close to the joint
  • Inability to move or apply pressure on the limb

Treatment

The management for growth plate fractures will depend on various factors such as type of fracture, how the bone is damaged, age, overall health of the child, degree of misalignment of the broken ends and other injuries.

Most cases can heal properly when managed with immobilization which involves a cast and limiting activity. In case the bone fragments moved and the fracture is not stable, surgery might be required.

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