As children grow their bones strengthen, but throughout development, they are more susceptible to growth plate fracture. Growth plates cartilage form near the end of the bones and is the last part of a child’s bone to harden, making them vulnerable to fracture. The growth plate functions as a guide for bone growth, dictating the future length and shape of the mature bone. Without immediate attention following a growth plate fracture the child could develop a shortened or crooked limb. About 15% to 30% of all childhood fractures are growth plate fractures, but serious complications are rare if the condition is treated promptly.

Anatomy

Growth plates are found at both ends of each long bong. Long bones grow from the ends, not the center. The growth plate sits tightly in between the shaft of the bone and the end of the bone. Once the child is fully-grown the plates harden into solid bone.

Types of Fracture

Growth plate fractures most commonly occur in the fingers, forearm and the long bones of the leg. Fractures can be classified into five distinct categories.

Type I Fracture The bone end and the bone shaft are separated, and the growth plate is disrupted. The fracture breaks through the bone at the growth plate.

Type II Fracture This sort of fracture breaks through the bone at the growth plate and cracks through the bone shaft. It is the most commonly reported type of fracture.

Type III Fracture With this kind of fracture the break crosses through an area of the growth plate and breaks off a piece of the bone end. Type III fractures typically occur among older children who are nearing the end of the growth.

Type IV Fracture These fractures are a break through the shaft, plate and bone end.

Type VI Fracture A compression force crushes the growth plate into the bone end with these fractures. This kind of fracture is rare.

Causes

Growth plate fractures typically occur because of a single event or force. It’s also common for them to form over time in response to repetitive stress to the bone. Overtraining during sports and extensive activity are also common causes. Any child that is still growing has the potential to develop a growth plate fracture; however certain factors make some children more vulnerable to injury. Girls finish growing before boys, and because of this, they are less likely to have growth plate fractures. Growth plate fractures most commonly occur during competitive sports or recreational activities. Teens report more fractures than any other age group.

Treatment

The treatment method your doctor chooses depends on the severity of the fracture, the age of the child, and which bone has been damaged.

Nonsurgical Treatment

Immobilizing and providing stability to the bone can treat most growth plate fractures. A doctor will apply a cast to protect the bones and hold them in place as the child heals.

Surgical Treatment

If the bone is unstable surgery may be recommended. Open reduction and internal fixation are the most commonly performed by doctors. During surgery bone fragments are placed into their original position. Safe recovery requires patients to wear a cast for a few weeks, so the area is immobilized as it heals.