It's nothing new for your little one to fall while playing, or to injure an arm or leg while running around. Usually, we think of it as a minor bruise or scrape, but sometimes it can be something more serious. Children's bones, in particular, have a weak spot that is specific to their growth. We call this the 'growth plate' . Today, we are talking about damage to this spot, that is, a bone fracture. This is medically known as a Salter-Harris Fracture .
What is a growth plate?
Simply put, a growth plate is a special area made of cartilage at the ends of a child’s long bones (such as those in their arms and legs). Think of it like the branch of a tree that extends. This area is where the child’s bones gradually grow and develop into the correct size and shape. When a child’s growth is complete, that is, when they reach adolescence, this cartilage gradually hardens and becomes normal bone.
These growth plates are mainly seen in:
- In the upper arm bone
- The two bones in the lower arm (radius and ulna)
- In the bones of the hand
- In the thigh bone
Since this area is very important for a child's development, we must definitely be concerned about any damage to this area.
Are there any types of Salter-Harris fractures?
Yes, doctors divide these fractures into five main types, depending on how they occur. You don't need to know much about this, but it's good to know a little about it so that it's easier to understand when the doctor explains it to you.
| Type of fracture | Simply explained |
|---|---|
| Type 1 | The growth plate completely separates, as if slipping off the end of the bone. |
| Type 2 | The fracture that occurs in the growth plate extends into the middle part (shaft) of the bone. This type is most common in children. |
| Type 3 | The fracture causes a piece of the growth plate and a piece of the end of the bone to separate. This is most common in young children, when the growth plates are starting to harden . |
| Type 4 | This is similar to type 3, but is a little more severe. The fracture extends across the growth plate, affecting the ends of the bone and the middle of the bone. |
| Type 5 | Excessive pressure on the bone causes the growth plate to become crushed and crushed. This is a rare but serious condition. |
How do I know if something like this has happened to my child? (Symptoms)
If you see these symptoms after a child falls, be concerned.
- Bone pain: The child cries out in pain when the injured area is touched.
- Swelling: The injured area is swollen.
- Abnormal appearance: An arm or leg appears stretched, bent, or otherwise abnormal.
- Inability to use: The child is unable to move or use the injured arm or leg.
- Blue/purple discoloration: Blood has seeped under the skin, giving a bruised appearance.
- Sensitivity to touch: The child feels pain even when the area is touched.
A very young child may not be able to tell you exactly when they are hurt. If your child suddenly stops using an arm or leg, holds the injured arm or leg close to their body, or limps when they walk, pay attention to this.
Why do children get these kinds of fractures?
The main reason for this is accidents.
- Falls: Falls while playing, riding a bike, climbing trees, etc.
- Sports accidents: Accidents that occur while playing sports such as cricket, football, basketball, and gymnastics.
- Vehicle accidents.
Additionally, overtraining in the same sport for a long period of time, especially before a child's body is fully developed, can cause continuous pressure on the growth plates, leading to these types of fractures.
Who is most at risk for this condition?
Although this can happen to any child, the risk is a little higher for some.
- Teens: These fractures are most commonly reported in this age group.
- Boys: Boys are about twice as likely to develop this condition as girls. This is because girls grow relatively quickly, and their growth plates harden into hard bones more quickly.
- Athletes: Children who frequently play jumping and running sports (basketball, gymnastics, skiing) are at higher risk.
Could this have a long-term impact?
The good news is that most of the time, if treated correctly and quickly, there are no long-term effects. The most important thing is to see a doctor and start treatment within a week of the accident.
However, very rarely, especially in severe fractures (Type 4, 5) or if treatment is delayed, some complications may occur.
- Malunion: The broken bone is incorrectly aligned.
- Nonunion: The fractured bone does not fit together properly.
- Growth retardation: The damaged bone may grow slowly. For example, that arm or leg may be slightly shorter than the other. In this case, surgery may be needed to prevent this.
How does a doctor diagnose this exactly?
When you take your child to a doctor, he or she will first examine the child carefully. They will look at the injury, swelling, and pain. They will also compare it to a healthy arm or leg. The doctor will ask you questions such as how the accident happened and when you first started experiencing symptoms.
After that, several tests are done to check the condition of the bone.
- X-ray: This can often detect a fracture.
- MRI or CT scan: Sometimes these tests may be needed to look for fractures or damage to surrounding tissues that are not clearly visible on an X-ray.
How is it treated?
The most common and effective treatment for this is a cast, such as Plaster of Paris (POP) or Fiberglass. This holds the broken bone in place and protects it until it heals. Your doctor will explain to you what type of cast your child needs, how long it should be in place, and how to care for it. A cast will usually be worn for about 4-6 weeks.
For severe fractures (grades 3, 4, or 5), surgery may be necessary. However, this is very rare. In this case, the surgeon realigns the bone fragments and uses internal fixation devices such as screws, pins, or plates to hold them in place. This is called ``Internal Fixation.'' After the bone heals, another minor surgery is sometimes needed to remove the devices.
When should I take my child to a doctor immediately?
If your child has a serious fall or accident, see a doctor immediately. Especially if you have the slightest suspicion that your child has a broken bone, take them to the nearest hospital's ETU (Emergency Treatment Unit) .
If you have any of the following symptoms, don't delay:
- If there is severe pain .
- If you can't even move an arm or a leg.
- If an arm or leg is clearly stretched out and looks oddly shaped .
- If the broken bone is visible through the skin .
- If it is severely swollen .
- If these symptoms are accompanied by a sudden bruised appearance or change in skin color .
Remember, allowing your child to run, jump, or play again before the bone has fully healed increases the risk of complications. So keep your child at rest until your doctor tells you to.
It's normal for parents to be scared when their child is injured. But these growth plate fractures are almost completely reversible if diagnosed and treated early. Time is of the essence. If you have any concerns, the best thing you can do is take your child to a doctor without delay.
Take-Home Message
- The growth plates at the ends of children's long bones are areas of their skeletal system that are slightly weaker and more easily damaged.
- If a child experiences pain, swelling, or stiffness in an arm or leg after a fall, don't assume it's just a simple bruise and definitely see a doctor.
- By identifying and treating such a fracture as soon as possible, the potential impact on the child's future bone development can be minimized.
- Most children recover completely without any long-term problems after proper treatment.
- It is very important to follow medical advice until your child is cleared to return to sports or normal activities.
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