Pediatric Orthopedic Surgeons treating a growth plate fracture

GROWTH PLATE INJURIES AND FRACTURES

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.

 

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Growth Plate Injuries and Fractures

Growth plates are tender regions of growing cartilage on the ends of a child’s bones. The growth plates, which help determine the length and form of the bone, are where the long bones in a child’s body develop rather than from the bone’s center outward. The growth plates are vulnerable to damage when a child’s bones are growing and developing. Untreated growth plate injuries might prevent the bone from growing normally. The growth plates become bone when a youngster is completely developed.

Growth Plate Injuries

The patches of developing cartilaginous tissue present at the ends of children’s long bones are known as growth plates, sometimes known as the epiphyseal plate or physis. The size and form of the adult bone are determined by these growth plates. Because they are not as hard as bones, the growth plates are more prone to injury and they can crack or break. Children and teens who are developing frequently have growth plate injuries. When a youngster has a serious joint injury, the growth plate may shatter rather than suffer ligament damage.

A child’s growth plate can fracture from any accident that would only be a sprain for an adult. Fractures commonly occur in children when they experience a growth plate injury. In contrast, growth plates can also suffer from overuse and repetitive motion injuries, just like adults. Sports participation is a common cause of growth plate injuries brought on by repeated action and misuse. Terms like these might also be used:

  1. Little League elbow
  2. Little League shoulder
  3. Jumper’s knee
  4. Saver’s disease

What are Growth Plate Fractures?

A child’s or adolescent’s growth plate can crack or break, and this condition is known as a growth plate fracture. A growth plate is a portion of cartilage-based tissue that is located at the extremities of the body’s long bones. Cartilage is a flexible, rubbery material (fingers, arms, and legs). Every long bone in the body has two growth plates, one on each end. As the kid develops, the growth plates dictate the length and form of the child’s bones. The growth plates will form into solid bone when a youngster has reached its maximum height.

Types of Growth Plate Fractures

Simple or open fractures are both possible:

  • Simple fractures are breaks or fissures in the bone that do not penetrate the skin.
  • Open fractures are breaks in which the bone protrudes through the skin.

Multiple Factors can Result in Growth Plate Fractures:

Traumatic fractures develop as a result of trauma, such as falling when jogging, cycling, or using a skateboard. Children who are healthy and have strong bones can sustain these kinds of wounds. The bone fractures when it is subjected to a force it cannot withstand. Most fractures result from trauma. Growth plate injuries can result from trauma that fractures bones. Children who repeatedly perform the same position or action for extended periods of time risk developing stress fractures. Additionally, repeated movements might harm development plates. Stress fractures are rare.

The reason why bones break pathologically is that they are weaker than usual. Typically, a pathologic fracture results from holes in the bone (bony cysts) or certain bone disorders, including brittle bone disorder (osteogenesis imperfecta), which causes bones to shatter readily. This is a rare reason for fractures.

Causes of Growth Plate Fractures

Growth plate fractures frequently result from a single incident, such as a fall or auto collision. As a result of recurrent stress on the bone, which can happen when a youngster overtrains in a sport, they can also develop gradually. Growth plate injuries can happen to any kid who is still developing, however, there are several things that may increase the risk:

  • Boys get growth plate fractures twice as frequently as females do because girls reach their full height earlier than boys.
  • When taking part in competitive sports like football, basketball, or gymnastics, growth plate fractures frequently happen.
  • When engaging in leisure activities like riding, sledding, skiing, or skating, many growth plate fractures happen.
  • Adolescence is the time when growth plate fractures are most common.

Symptoms of a Growth Plate Fracture

Depending on how bad the fracture is, different growth plate fracture symptoms may be present. A youngster may have moderate discomfort occasionally, while other times the damage may be more obvious and urgent. A growth plate fracture may cause the following symptoms:

  • Swelling or agony in the affected limb.
  • The wounded region has a clear malformation.
  • Inability to use or move the damaged region normally.
  • The wounded region may feel heated, bruised, or red.

Treatment of Growth Plate Injuries

The nature of the damage determines the treatment plan for growth plate injuries. Following an accident, therapy should begin as soon as feasible and often consists of one or more of the following.

Fracture Reduction

Following the standard alignment of fractured bones, the doctor places the afflicted limb in a cast or splint to inhibit movement and give the bone time to heal. Your kid or teen should minimize any activities that put pressure on the wounded region to assist encourage recovery. The doctor will typically need to realign the bones or joints in your child’s body if their injuries result in the ends of the broken bones being out of alignment (displaced). The name of this process is Fracture reduction. The method that surgeons use to fix bones depends on the kind of growth plate fracture that your kid has.  When a doctor does a closed reduction, they use their hands to set and position the bone.

Open Reduction

Based on the injury, some growth plate injuries and fractures will require surgery to align and stabilize the bones. The surgery usually requires smooth metal pins to hold the bone in place to cause the proper fusion of the damaged growth plate. After surgery, doctors often use a cast to immobilize the injured area to allow proper healing.  The cast should be left in place until the injury is fully healed.  

The bone can, for instance, be misaligned or a little longer or shorter than intended. Your doctor will often advise follow-up visits to check on the progress of the bone and look for any changes in growth and development in order to help prevent issues with bone growth. Most kids and teenagers who get prompt treatment recover without experiencing further development issues. Depending on the sort of activity and your kid’s recuperation, you can determine when your child can resume normal activities and sports.

Exercises for Enhancing Strength and Motion

After the wound has healed, your child’s doctor could suggest activities to strengthen the muscles that support the wounded portion of the bone. A stronger youngster will be better able to move the joint as it should be able to with the aid of strengthening. To create an activity program, a physical therapist can collaborate with your kid.

How is a Fractured Growth Plate Managed?

In order to prevent it from impeding normal bone growth, a growth plate fracture has to be treated very away. The severity of the growth plate and connected bone fracture will determine the appropriate course of treatment. The various growth plate fracture types are handled in the following manner:

Type I fracture

In order to preserve the growth plate as it heals, the doctor may frequently advise the patient to wear a cast. In most situations, the bone will have healed properly when the cast is removed.

Type II fracture

To ensure that the bone heals properly, a cast could be necessary, and the doctor might also need to fix the bone—that is, move it into position. After that, normal healing happens.

Type III fracture

In such cases, surgery may be recommended, but it is usually curative.

Type IV fracture

Surgery is frequently required for this kind of break. To make sure all the broken components are aligned for healing, metal screws, pins, or plates may also be advised.

Type V fracture

Surgery is necessary for this fracture since it is a significant injury that will stunt the child’s growth.

Conclusion

Despite the fact that every person is unique, recovery from a growth plate fracture usually takes several weeks. In order to keep an eye on the child and ensure that the bones are continuing to repair and grow normally, the doctor may also ask for numerous follow-up sessions to conduct X-rays to ensure that bone growth is proceeding correctly. The patient’s doctor can advise specific workouts or physical therapy once the fracture has healed. This will aid in the patient’s recovery of mobility, strengthen the muscles around the wounded area, and minimize any stiffness that may develop after weeks of immobilization.

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