Growth-Plate Fracture

     The bones of children and adults share many of the same risks for injury. However, a child's bones are also subject to a unique injury called a growth plate fracture. Growth plate fractures can result from a single traumatic event, such as a fall or automobile accident, or from chronic stress and overuse.

     Growth plates are areas of developing cartilage tissue near the ends of long bones. The growth plate regulates and helps determine the length and shape of the mature bone. Growth plates are located between the widened part of the shaft of the bone (the metaphysis) and the end of the bone (the epiphysis).

     The long bones of the body do not grow from the center outward. Instead, growth occurs at each end of the bone around the growth plate. When a child becomes full-grown, the growth plates harden into solid bone.

     Because growth plates are the last portion of bones to harden (ossify), they are vulnerable to fracture. In fact, because muscles and bones develop at different speeds, a child's bones may be weaker than the ligament tissues that connect the bones to other bones.

     Approximately 15% to 30% of all childhood fractures are growth plate fractures. These often require immediate attention because the long-term consequences may include limbs that are crooked or of unequal length. It is important to seek evaluation and treatment by an orthopedic surgeon experienced in orthopedic trauma.

     Although growth plate injuries are common, and serious problems are rare, growth deformity occurs in 1% to 10% of all growth plate injuries.

     Growth plate fractures must be watched carefully for long-term results. In some cases, a bony bridge will form across the fracture line that prevents the bone from getting longer or causes the bone to curve. Orthopedic surgeons have developed techniques to remove the bony bar and insert fat, cartilage, or other materials to prevent it from reforming.

     In other cases, the fracture actually stimulates growth so that the injured bone is longer than the uninjured bone. Surgical techniques can help achieve a more even length.

     Regular follow-up visits to the doctor should continue for at least a year after the fracture.

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