Many children are involved in sports and recreational activities to have fun, be competitive and be a part of a team, unfortunately, injuries can occur which include fractures, strains and sprains. One common injury found in children is growth plate fractures. Growth plates are located at the ends of the bone and are a much softer part of bone where growth occurs. They are also the weakest section of the bone and are sometimes weaker than ligaments and tendons.  These fractures usually occur in children between the ages of 9 and 15 years.  Growth plate fractures need immediate attention because it can affect the way the bone grows; however, they can heal without complications if treated correctly.  

Symptoms:

-         Severe pain that does not go away.

-         Inability to move the affected area

-         Inability to put pressure or weight on the affected area

-         Common injury sites are the fingers, wrist, forearm and lower leg 

Causes:

A fall or blow to the limb.  Examples are car accidents, competitive sports like gymnastics or football and recreational activities like biking, sledding or skiing. 

Risk Factors:

Growth plate fractures are found more often in boys between the ages of 9 and 15 years.  Girls age 12 and older experience less fractures because the growth plates have matured and have been replaced with solid bone. 

Complications:

-         Increased risk of deformity, twisted or stunted growth of the bone depends on the severity of the injury.  For example, if the bone or joint is crushed, shifted or shattered.

-         Age of the child

-         Location of injury.  Some growth plates grow more than others.  The risk for complications increase with injuries to the growth plates that grow the most.  An example is the knee.

-         The good news is that 85% of growth plate fractures heal with no complications.

Tests and Diagnosis:

      -    MRI, ultrasound, or CT scan are performed

      -    X-rays are performed to compare limbs to see any differences. However, x-rays can not detect fractures because the growth plates are softer than normal bone.

Treatment:

-         Less serious fractures are put in a splint or a cast.

-         If part of the bone is separated from the shaft, then surgery is needed.

-         The child may be monitored as the bone grows every 3-6 months, comparing limbs for at least 2 years or until the child is finished growing. 

Physical Therapy and Growth Plate fractures:

 

Physical therapy is not needed for minor growth plate fractures.  However, if the fracture is severe or if the child wants to get back to playing sports then physical therapy and exercise will be needed to regain strength, flexibility and endurance if the doctor feels it is necessary.  If the child wants to get back to playing sports then the following are required:

-         Full range of motion of the joint of the affected limb.

-         Good agility (jumping, hopping etc.) for the lower extremities.

-         More than 85% strength in the affected area when compared to the opposite side

-         No limping if the fracture occurred in a lower extremity. 

All of the above can be gained through physical therapy. Do not hesitate to contact the Sports Physical Therapy location nearest you with any questions or if you would like to make an appointment to treat a growth plate fracture.