GROWTH PLATES INJURY
A growth plate injury is any fracture (cracks or breaks) to the growth plates, the area of growing tissue near the end of the long bones in children and adolescents.
- Growth plates determine how long children’s bone will be once they are matured. They are found in many places, including the thigh, forearm, and hand.
- Adults don’t have growth plates, only young kids and teens do. When growth is complete during adolescence, the growth plate is replaced by solid bones.
- Growth plates are the weakest and softest area of the growing skeleton, even weaker than the surrounding ligaments and tendons that connect bones to bones and muscles, making them easily injured.
- When children or teens break bones, they may damage their growth plates as well.
- Growth plates injury often need immediate treatment because they can affect how bone will grow.
- This is a serious problem because it can permanently stop a bone’s development and change how it functions, stunting physical development and causing functional problems.
- The injured bone can end up more crooked, shorter than its opposite limb, or the bone may grow in an uneven way.
CAUSES
Growth plates injury are often caused by trauma such as falling or being hit hard, as might occur in:
- A car accident
- Recreational activities, such as skiing, skateboarding, biking, sledding
- Competitive sports, such as football, basketball, running, dancing, or gymnastics
Injury can also come from overuse. This can be caused by chronic stress on the shoulder from too much ball-throwing such as seen in baseball pitchers. Some children and young people who participate in gymnastics, or long-distance running can also get injuries from overuse.
SYMPTOMS
- Warmth and swelling near a joint
- Pain and tenderness, especially when pressure is applied to the injured area
- Inability to move the affected area
A child should be taken to a medical professional if:
- A fracture is suspected
- There is a visible deformity in the child’s arm or legs
- There is trouble playing sports because of persistent pain
DIAGNOSIS AND TREATMENT
To make a diagnosis, the doctor will first determine how the injury happened.
The doctor will then examine the child and use x-rays to detect the kind of fracture that the child has. Growth plates are hard to interpret on X-rays, so doctors may ask for X-rays of both the injured limb and the opposite limb so they can be compared.
For more serious injuries, other imaging tests such as MRI scan, CT scan, or ultrasound that can visualize soft tissue may be ordered.
TREATMENT
Treatment option depends on the severity of the injury, the age of the child and the location of the injury.
For mild cases, a cast or splint may usually be required
If the bones are displaced, a procedure called reduction may be used to put them back in their right position. There are two types of reduction: a closed reduction where the surgeon gently moves the bone back into the right position without an incision or an open reduction (for more complicated injury) where the surgeon makes an incision before moving the bone to the right position. Surgical plates, screws, or wire are used to keep the bone in place.
In more severe cases, reconstructive surgery may be needed.