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When Your Child Has a Growth Plate Fracture

When you're in the ER with your child because they broke a bone, you may hear the doctor say they need to check if it's a "growth plate" fracture. It can sound a little scary, but most injuries like that heal easily.  There can be complications, though, if it's not treated correctly or if the problem is severe enough.

Growth plates are areas of soft tissue at the ends of your child's long bones. They are found in many places, including the thigh, forearm, and hand. 

As the name suggests, growth plates help your child's bones grow. Adults don't have them -- only young kids or teens do. Once your child stops growing, they turn into bone. The age this happens varies, but it's usually by the time they reach 20.

Because the growth plates are soft, they're easily injured. When that happens it's called a "growth plate fracture."

Complications

One problem is something your child's doctor may call "growth arrest." This is when the injury causes their bone to stop growing. They could end up with one leg or arm shorter than the other.

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Your child's likely to get crooked legs or one leg shorter than the other if their growth plates were damaged at their knee. That's because there are a lot of nerves and blood vessels in that area that can be hurt along with the growth plate.

Sometimes, a growth plate fracture can also cause the bone to grow more, but this has the same result: One limb ends up longer than the other.

A less common problem is when a ridge develops along the fracture line. This can also interfere with the bone's growth or cause it to curve.

If the bone is sticking out of the skin, there's also a chance of infection, which can damage the growth plate even more.

Younger children are more likely to get complications because their bones still have a lot of growing to do. But one benefit is that younger bones tend to heal better.

Treatment

To come up with a treatment plan, the doctor will take into account your child's age, general health, and if there are any related injuries.

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If the fracture isn't severe and the broken parts of the bone still line up right, your child's doctor might just put on a cast, splint, or brace. Your child won't be able to move their limb that way, which gives the growth plate time and space to heal. Immobilizing the fracture will also help control pain.

If the fractured bits of bone aren't meeting in a straight line, your doctor will have to move them back into place. This is called a "reduction" and can be done either with or without surgery.

If it's done without surgery, the doctor usually just moves the bones back in line with their hands without cutting into the skin. This is called "manipulation" and can be done in the emergency room or an operating room. Your child will get pain medication so he don't feel anything.

If surgery is done, the doctor cuts into the skin, puts the bones back in line, and puts in screws, wires, rods, pins, or metal plates to hold the pieces together. Your child will have to wear a cast until the bones heal. This can take from a few weeks to 2 months or more.

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If a ridge forms at the fracture line, your child's doctor may recommend surgery to remove the ridge. They can then pad the area with fat or another material to keep it from growing back.

Most of the time, kids get back to normal after a growth plate fracture without any lasting effects. One exception is if the growth plate is crushed. When that happens, the bone will almost always grow differently.

After the injury has healed, your child's doctor may suggest exercises to strengthen the injured area and make sure their limb moves like it's supposed to.

Some children need another operation, such as reconstructive surgery, if the injury is serious enough.

Your child should have follow-up appointments for at least a year. Once everything is healed and your doctor gives their OK, your child can get back to having fun with the activities they love.

WebMD Medical Reference Reviewed by Dan Brennan, MD on October 30, 2019

Sources

SOURCES:

National Institute of Arthritis and Musculoskeletal and Skin Diseases: "Questions and Answers About Growth Plate Injuries."

American Academy of Orthopaedic Surgeons: "Growth Plate Fractures."

Merck Manuals: "Growth Plate Fractures."

Cincinnati Children's Hospital: "Fractures in Children."

Boston Children's Hospital: "Growth Plate Fractures in Children."

Seattle Children's Hospital: "Fractures and Growth Plate Injuries."

Nemours Foundation: "Growth Plate Injuries."

National Institute of Arthritis and Musculoskeletal and Skin Diseases: "Questions and Answers About Growth Plate Injuries."

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