Growth plate injuries in children.
by Mary Alice Cookson
Whenever a child breaks a bone, whether it’s in a pinkie finger or a leg, parents and caregivers worry. How long will it take to heal? Will the bone heal properly? How can I keep my child comfortable – even happy – while recovering? Just how long is this recovery process going to take anyhow and will we all survive it?
When an injury involves the growth plate of the bone – specifically, when the growth plate is fractured – the situation can be especially worrisome.
In a worst-case scenario, if a child’s growth plate is disrupted, the bone can undergo what is called “growth arrest,” which means the bone stops growing, according to Avi J. Grunin, M.D., a non-surgical pediatric sports medicine doctor with Harvard Vanguard Medical Associates, Boston. “This is very rare and usually only happens if the fracture isn’t diagnosed and treated properly; but it can happen,” he says. “This can be concerning since the other bones can continue to grow, and this affects how the joint near the injury functions.”
What Is the Growth Plate?
The growth plate is “a special type of cartilage also called growth cartilage,” says Grunin. This cartilage is found at the end of the long bones of a body that’s still growing – in the limbs, for example. It is not present in adults or in teens who have already stopped growing. Typically girls stop growing about age 16; boys at 18, Grunin estimates.
Growth plate fractures most commonly occur in teens at around ages 11-13 for girls (who mature faster than boys) and in boys ages 14-16. But while they are common with teens, Grunin says these fractures can happen in any growing child who suffers an injury. “Around 15 to 20 percent of pediatric fractures involve the growth plate, which is the weakest part of the bone,” he notes.
This type of fracture is often the result of a sports injury for a child athlete involved in a contact, “collision” sport, but can also be the result of falling off a bike. “Frequently, we see them in soccer and football,” says Grunin. “Teens aren’t out of the woods for growth plate fractures as long as they’re still growing.”
Treated Like Any Other Fracture
“If your child doesn’t want to move a leg or arm, see a doctor right away,” Grunin advises. “The doctor will decide if the broken bone is from a growth plate. Children tend to heal very well. As long as they are evaluated and treated properly, kids bounce back quickly.” So, if a child has a growth plate fracture, chances are that it will heal normally.
If a child has an injury where the pain is right over a bone and the child doesn’t want to put weight on it, a doctor will prescribe an x-ray. Most fractured bones will be treated with a splint or cast.
During the healing process, Grunin explains, “It may be normal for a child to continue to have discomfort or pain initially while in the cast, but that does tend to improve quickly. If, however, the child continues with significant pain or, more importantly, worsening pain, this is a reason to contact the doctor immediately.”
More significant growth plate fractures may require surgery. “Usually it is fairly easy to diagnose if it needs surgery or not,” Grunin points out. “The vast majority [of cases] don’t need surgery. In the ones that do – it’s something you would want to act on sooner than later. You don’t want to let a lot of time lapse.”
Once a child is in a cast, the pain is reduced significantly. The hardest obstacle may be that the child won’t be able to participate in sports or certain activities.
by Mary Alice Cookson
It’s good for parents to have alternative plans for the child. “These days, kids don’t just do one sport in one season,” says Grunin. “They are competitive.” If the child’s social life is tied to the sport, parents need to come up with other activities, such as arts and crafts, or offer opportunities for hanging out with friends, to fill the void that is created.