Why to Treat Growth Plate Fractures Quickly

A growth plate is a small area of cartilage at each end of a bone that allows the bone to grow. As children grow, those areas start to close, allowing the child’s bone to get bigger.

When a child injures a growth plate, it has the potential to cause long-lasting issues because they are at risk of stunting their growth or developing arthritis in the future, depending on the type of injury. For this reason, growth plate injuries need to be treated as quickly as possible.

Zana Rashed, PA, specializes in orthopedics at our Orthopedic Urgent Care in Victor and explains how common growth plate injuries are, how to recognize them, and the best ways to treat growth plate injuries.

Common growth plate injuries

Since children are born with growth plates in most bones, growth plate injuries can happen to many different areas of the body. This may include:

• hands
• arms
• legs
• feet
• knees
• wrists

“A child might trip and fall over onto an outstretched hand, roll their ankle while stepping on uneven ground, or any other number of situations,” Rashed said.

Signs of a growth plate injury

Unless you are trained as a specialized orthopedic provider, knowing how to determine if a child’s injury is a growth plate fracture is difficult.

Orthopedic specialists know where growth plates are in pediatric patients, so they will look for some warning signs, such as:

• being unable to put pressure on affected area
• limited movement of affected area
• visibly crooked or abnormal shape
• long-lasting limp
• swelling and tender feeling near the end of a bone

When looking for a potential growth plate injury, a child will have x-rays done to help the orthopedic provider see where their growth plate is located. This helps the provider determine if there might be a growth plate fracture or other injury.

Having an orthopedic specialist perform a clinical exam and examine the x-ray images is key to getting a correct diagnosis. Because growth plates are cartilage, some fractures do not show up on x-rays. Having a provider carefully examine the injured area can help to confirm an injury and direct them toward the right treatment.

Sometimes a follow-up MRI may be needed to make a definitive diagnosis.

Diagnosing and treating growth plate injuries

One of the main reasons that growth plate injuries need to be treated quickly is because children’s bones heal quickly. To make sure they heal properly, time is of the essence.

Like most injuries, the type of treatment depends on several factors. Providers will take into consideration factors such as:

• additional injuries
• age of the child
• location of bone
• type of fracture

Orthopedic providers will classify the level of severity using the Salter-Harris system, which is made specifically for growth plate fractures. The Salter-Harris system has five types of fractures – one being the least severe and five being the most severe.

For most growth plate injuries, providers will realign the broken bone (called fracture reduction) before placing it inside of a cast or splint.

“We will usually immobilize the affected area using a cast or splint for about two weeks, and then reevaluate the injury using x-rays,” Rashed said.

If the fracture is unstable and determined to be more severe, orthopedic specialists may perform a surgical reduction where they put the bone back in its normal place and hold it together using screws or pins, then placing the patient in a cast to let the injury heal.

Recovery for growth plate injuries

Children are often able to recover quickly from growth plate injuries. The length of time that a child has their bone immobilized with a cast or splint depends on how severe their injury is.

Some orthopedic providers will recommend that a child do exercises to strengthen the muscles and tendons that surround the injury so they can make a strong recovery.