All you need to know about Growth Plate Injuries.
Know your ailment well, so you can manage it better!!
Here we come with Growth Plate Injuries today!
What are Growth Plate Injuries?
Growth plates are areas of growing tissues that cause children and adolescents to develop long bones. When a crack or fracture occurs near or at the end of a long bone, injuries to the growth plate happen. The weakest part of the growing skeleton is the growth layer.
Growth plate injuries usually happen at the:
- Bones of the legs.
- Wrist.
- Ankle.
- Foot.
- Hip bone.
When you finish growing, the plates of growth close and are replaced by strong bone.
Classification / Types of Growth Plate Fractures:
Several classification schemes have been developed to categorize the various forms of fractures on the growth plate. The Salter-Harris method, described below, is perhaps the most commonly used by the doctors.
Type I Fractures
These fractures at the growth plate tear through the bone, separate the bone end from the bone shaft, and completely destroy the growth plate.
Type II Fractures
These fractures at the growth plate tear through part of the bone and split through the bone shaft as well. This is the most frequent form of fracture from the growth plate.
Type III Fractures
These fractures penetrate a section of the growth plate and split a corner of the bone end off. Such fractures are more common in older children.
Type IV Fractures
These fractures break through the shaft of the bone, the growth plate, and the bone ends.
Type V Fractures
These fractures result from a compressive force due to crushing damage to the growth plate. Such fractures are uncommon.
Interesting Statistic:
It is 2.5-fold more common in boys and can be bilateral in up to 37% of cases.
What are the symptoms of Growth Plate Injuries?
Your child or teen may experience symptoms of an injury to the growth plate when your kid:
- Stops playing because of pain after a sudden injury.
- Limits the amount of time playing because of an old injury.
- Has changes in the way their arm or leg bends.
- Cannot move an arm or leg because of pain.
- Has pain that continues after an overuse injury.
What causes Growth Plate Injury?
Development plate accidents occur for a number of reasons. Most of them happen after a sudden crash, like falling or taking a heavy hit to the leg. The most common cause of injuries at the growth plate includes:
- Falling down.
- Competitive sports (like football).
- Recreational activities.
Often damage to the growth plate occurs when your child overuses a certain part of the body. For instance:
- Gymnasts who practice for hours on the uneven bars.
- Long-distance runners.
- Baseball pitchers perfecting their curveballs.
Some reasons for injuries to the growth plates are:
- Child abuse.
- Injury from extreme cold (for example, frostbite).
- Radiation used to treat certain cancers.
- Medications, for example, steroids.
- Neurological disorders that cause people to lose their balance and fall.
- Some inherited disorders.
- Bone infections.
- Metabolic disease, such as kidney failure and hormone disorders.
What are the complications of Growth Plate injuries?
One issue is something that the doctor of your child may call “growth arrest.” That’s when the injury causes his bone to stop developing. He may end up with one leg or arm shorter than the other.
If his growth plates were damaged at his knee, your child is likely to get crooked legs or one leg shorter than the other. This is because in that area there are a lot of nerves and blood vessels that can be damaged along with the growth plate.
A growth plate fracture can also sometimes cause the bone to expand further, but this has the same result: one limb ends up longer than the other. As a ridge forms along the fracture line, a less common issue is. This can also interfere with the development of the bone, or cause it to curve. If the bone sticks out of the skin, there is also a risk of infection, which will further damage the growth plate.
Younger kids are more likely to get injuries because their bones still have plenty to develop. One advantage, however, is that younger bones appear to heal faster.
Who gets this disease?
- Injuries from the rising plate happen to children and teenagers. In boys this injury occurs twice as much as in girls.
How is Growth plate injury diagnosed?
Doctor’s test for growth plate injuries by:
Asking about the injury.
- Examining your child.
- Ordering x-rays.
Sometimes the fracture in the growth plate may be hard to see. Your doctor may order other tests to look closely at area of the injury or pain, such as:
- CT scan, a special x-ray that helps to see the growth plate.
- MRI, a test that uses magnetic energy to look inside the body.
- Ultrasound, a test that uses sound waves to look inside the body.
What is the treatment for Growth Plate Injury?
The doctor will take into account the age of your child, general health and whether there are any associated accidents to establish a treatment plan.
If the fracture is not serious and the broken bone parts still line up correctly, your child’s doctor can either put on a cast, splint, or brace. Your child can’t turn his limb that way, which allows time and space to repair the growth plate. Setting the fracture off can also help control pain.
If the broken bone parts do not align in a straight line, the doctor will need to move them back into position. This is known as “reduction” and can be achieved with or without surgery.
If performed without surgery, normally the doctor only pushes the bones back in line with his hands without cutting them into the tissue. This is called “manipulation” which can be achieved in an operating room or emergency department. Your child takes medicine for pain so that he doesn’t feel anything.
When the surgery is completed, the doctor removes the skin, brings the bones back in place, and holds the pieces together in screws, wires, tubes, pins, or metal plates. Your child must wear a brace before the bones heal. This can take up to 2 months or more, from a few weeks.
If the fracture line forms a ridge, your child’s doctor can suggest surgery to remove the ridge. He can then pad the area with fat or other material to prevent it from returning to growth.
Most of the time after a growth plate fracture children return to normal without any permanent effects. One exception is in crushing the growth layer. When that happens, the bone will develop differently, almost always.
After the injury has healed, your child’s physician can prescribe exercises to stabilize the injured area and make sure his limb works as it should.
Some kids require another procedure, for example, reconstructive surgery, if the injury is too severe.
Your child should have at least one year of follow up appointments. When all is fixed and your doctor gives his Approval, your child will get back to having fun with the things he enjoys.
Living with the disease:
Most growth plate injuries get better and do not cause your child or teen any permanent issues. The bone stops developing sometimes and ends shorter than the other limb. A broken leg for example might end up shorter than the other leg. Or, if only part of the growth plate gets damaged, when only part of the bone keeps growing, the limb can become crooked. Long-standing complications with knee injuries are more severe.
References:
https://orthoinfo.aaos.org/en/diseases--conditions/growth-plate-fractures
https://www.niams.nih.gov/health-topics/growth-plate-injuries
https://www.webmd.com/children/growth-plate-fracture#1
By,
Gopala Krishna Varshith,
Content Developer & Editor,
Clipo.
