What are the other Names for this Condition? (Also known as/Synonyms)

• Epiphyseal Plate Fractures
• Fractures of the Physis
• Salter-Harris Fractures

What is Growth Plate Fractures? Definition/Background Information)

• The growth plates in the body are cartilage plates located on each end of the long bones. They are also known as the epiphyseal plates or physis. The growth plates are responsible for bone growth in children and adolescents by producing new bone tissue
• Growth Plate Fractures are injuries that cause a break or crack affecting the layer of cartilage located near the end of the long bones
• These fractures are usually caused by any high-energy impact such as an automobile accident or fall. Individuals who participate in contact or high-impact sports, such as football or hockey, also have an increased risk of Growth Plate Fractures
• The treatment for the condition depends on where the injury occurred and the type of fracture sustained. When properly diagnosed and treated, a high percentage of Growth Plate Fractures heal without any serious complications

Growth Plate Fractures are classified into five types:

• Type I Growth Plate Fractures: These fractures break directly through part of the bone at the growth plate in which the end bone separates from the bone shaft
• Type II Growth Plate Fractures: These fractures break directly through part of the bone at the growth plate in which the bone shaft is also fractured
• Type III Growth Plate Fractures: Type III Fractures break directly through the growth plate in which pieces of the end bone break-off
• Type IV Growth Plate Fractures: Fractures that break directly through the bone shaft, growth plate, and the end bone
• Type V Growth Plate Fractures: Fractures that occur due to a serious injury to the growth plate

Who gets Growth Plate Fractures? (Age and Sex Distribution)

• Growth Plate Fractures are two times more likely to occur in male children and adolescents between the ages of 9 to 15 years
• The incidence in female children is usually between the ages of 11 to 12 years
• No ethnic or racial preference is seen

What are the Risk Factors for Growth Plate Fractures? (Predisposing Factors)

The risk factors for Growth Plate Fractures include:

• Male children or adolescents are two times more likely to sustain a Growth Plate Fracture than females
• Participation in any rough or high-impact sport
• Any participation in recreational activities such as biking, skiing, or skateboarding

What are the Causes of Growth Plate Fractures? (Etiology)

Common causes of Growth Plate Fractures in Children include:

• A high-energy impact traumatic event such as an automobile accident
• A fall from a significant height
• Participation in any rough or high-impact sport such as football or basketball
• Children or adolescents who participate in recreational activities such as cycling, skiing, or skateboarding

What are the Signs and Symptoms of Growth Plate Fractures?

The signs and symptoms of Growth Plate Fractures in Children include:

• Pain and tenderness on the affected area
• Decreased range of motion or inability to apply weight to the affected area
• Swelling at the end of the long bone of the hands or legs, close to the joint
• Visible deformity of the bone

How is Growth Plate Fractures Diagnosed?

Physicians may use the following tools to diagnose Growth Plate Fractures:

• Physical examination: Since a child’s bone heals quickly, it is important for a physician to examine the affected area immediately. In addition to this, the physician will discuss the child’s symptoms and complete medical history before arriving at a definitive diagnosis
• X-ray of the affected area: Physicians will likely order an x-ray to help determine if a Growth Plate Fracture has occurred. However, since the growth plates are still developing, it can be difficult to interpret the results, and the physician may order x-rays of the non-affected region or bone for comparison
• Computerized tomography (CT) scan of the affected area: A CT scan takes a series of x-ray images from several different angles. These images are then merged to create cross-sectional images of bones and soft tissues of the body, which then allows the physician to examine the affected limb and surrounding structures to confirm the diagnosis
• Magnetic resonance imaging (MRI) of the affected area: An MRI is a detailed scan that uses a magnetic field to generate thorough images of the interior bones and soft tissues of the affected limb. This also helps to confirm the diagnosis

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Growth Plate Fractures?

The complications of Growth Plate Fractures may include:

• Uneven limb length or limb distortion due to disruption of growth, if not properly treated
• Onset of degenerative joint disease
• However, the majority of Growth Plate Fractures heal without any complications.

How is Growth Plate Fractures Treated?

The treatment for Growth Plate Fractures depends on the injury location, the type of fracture sustained, and the child’s age and health status.

Nonsurgical treatment for Growth Plate Fractures may include:

• Complete immobilization of the affected area with a cast to help restrict movement
• Closed reduction is a nonsurgical treatment that involves realigning the bone back to its original position, without making an incision at the fracture site. This procedure is usually performed under general anesthesia or by conscious sedation using muscle relaxants

Surgical treatment for Growth Plate Fractures may include:

• Open reduction and internal fixation (ORIF): Open reduction is a surgical procedure to realign the fractured bone to its original position. Surgical hardware (such as plates, screws, or rods) is then used to stabilize the fractured bone under the skin

How can Growth Plate Fractures be Prevented?

To prevent a Growth Plate Fracture, children should be careful and consciously aware while performing any physical activities, such as sports, or even some normal daily activities that could lead to situations involving accidents. Children must be provided a safe environment to work, study, or play. Any possible dangers should also be anticipated and appropriate safety measures adopted.

A few ways to further help prevent unwanted injuries or a Growth Plate Fracture may include:

• Individuals who participate in any high-risk sports should wear appropriate safety equipment to help prevent the possibility of such fractures
• Wearing appropriate footwear (such as the proper shoe size) may help prevent accidents
• Use of seat belts while traveling in an automobile
• Consuming foods rich in calcium, such as milk, yogurt, and cheese, help build bone strength. A regular diet with appropriate calcium intake is recommended, even after a Growth Plate Fracture

What is the Prognosis of Growth Plate Fractures? (Outcomes/Resolutions)

• The long-term prognosis of Growth Plate Fractures is usually good in a majority of the children
• Overall, it can take several weeks for the injury to heal. If a cast is used to immobilize the fracture, the time required to wear the cast depends on the severity of the fracture
• Physicians may recommend certain strengthening exercises for the muscles that support the affected area. This can help the child regain full strength and range of motion in the affected joints
• In some cases, abnormal growth due to permanent damage to the growth plate may occur

Additional and Relevant Useful Information for Growth Plate Fractures:

• Approximately 15-30% of all childhood fractures are Growth Plate Fractures
• The majority of Growth Fractures occur in the long bones of the fingers; fractures are also common in the forearm (radius) and the leg (tibia and fibula)