Is your child suffering from a fracture where their bones are growing? Let's talk about Growth Plate Fractures!

Did your child suddenly fall while playing? Or come home from sports practice with a sore arm or leg? You may have heard that sometimes young children break their bones, but you may not be aware of this special condition called Growth Plate Fractures . Don't worry, this is something that can often be treated successfully. Let's talk about it in detail.

What are these growth plates? Why are they important?

Simply put, growth plates are special pieces of cartilage at the ends of long bones (such as those in the arms and legs) in young children and adults. Think of them as new shoots growing from the end of a tree branch. These are what help bones grow, grow, and form properly. When a child is fully grown, meaning they are no longer growing taller, these growth plates gradually turn into hard bones.

These growth plates are located at the ends of bones like this:

• Humerus - This is the bone in the upper arm.
• Radius and Ulna - These are located in your child's arm, just below the elbow.
• Metacarpals - Small bones on the inside of the hand.
• Femur - The longest bone in our body, located in the thigh.

These are the main ones. So, if something happens to these growth plates, that is, if there is a fracture, that is what we call a growth plate fracture . If a child's bone hurts, is swollen, or looks different from an arm or leg, or looks stretched, you should definitely see a doctor. Since these types of fractures take several weeks to heal, it is very important to get a diagnosis and treatment quickly.

Are there types of growth plate fractures?

Yes, doctors use a special system to classify these fractures. It's called the Salter-Harris classification . There are five main types:

1. Type 1: This is when the cartilage at the growth plate separates from the end of the bone, as if something had been glued on and then come off.

2. Type 2: In this type, the fracture occurs in the growth plate and extends into the shaft of the bone. This type is most common in children.

3. Type 3: This is a fracture where a piece of the growth plate and the end of the bone that is attached to it break off. This is a bit larger, meaning it is more common in teenagers, as their growth plates are gradually turning into hard bones.

4. Type 4: This is similar to type 3, but is a little more severe. A piece of the growth plate, a piece of the end of the bone, and a piece of the long part of the bone are broken off.

5. Type 5: This is caused by crushing pressure on the bone, resulting in damage to the growth plate. This is the least common type and can be a little more serious.

This classification is important for doctors to decide what kind of treatment to give, how long it will take to recover, and what complications may arise in the future.

How common are these growth plate fractures?

Growth plate fractures are actually one of the most common bone injuries in children. They account for about one-third of all bone fractures in children. Therefore, it is important to be aware of this.

What are the symptoms of a growth plate rupture?

If your child has a growth plate fracture, you may notice symptoms like these:

• Pain: There may be severe pain, especially over or in the area of ​​a bone.
• Limbs look different: The injured arm or leg may appear to be stretched, bent, or otherwise deformed.
• Inability to move: You may not be able to properly bend, straighten, or put weight on the injured area.
• Swelling: The injured area may swell.
• Discoloration or bruising: Sometimes bruises may turn blue or purple.
• Tenderness: The child may feel pain when touched .

Imagine your son comes home from playing cricket and says his wrist hurts, he can't move it, and it's a little swollen. In that case, it could be a growth plate fracture.

A small child may not be able to tell you when they are hurt. At that time, you may see things like this:

• Suddenly, the use of an arm or leg is reduced.
• The injured arm/leg is held close to the body and protected.
• They cry, scream, and refuse to be touched.
• He limps when he walks.

If you see something like this, don't waste time and see a doctor.

What are the causes of these growth plate fractures?

Most of the time, these fractures occur due to sudden traumas . For example:

• Falls: Such as falling from a tree, falling while playing, or falling down stairs.
• Traffic accidents: Accidents that happen while on the road.
• Sports accidents: Accidents that occur while playing sports like cricket, football, and netball.

For example, Nisal's son suddenly slipped and fell while running on the playground. His ankle started hurting badly. It was only when he went to the hospital that he learned that it was a growth plate fracture.

Also, overtraining the same sport , especially before the child's body is fully developed, can cause repetitive stress on the growth plates, which can lead to this type of fracture. Therefore, it is not good for a child to play the same sport all year long until their body is fully developed. Rest is also very important.

Who is at higher risk for these growth plate fractures?

Although any child can be at risk of this type of accident, some children are at a slightly higher risk:

• Teens: These breaks are most commonly seen among children between the ages of 13-17.
• Boys: Boys are about twice as likely to have these fractures as girls . This is because girls generally grow a little faster, and their bones harden more quickly. Boys are also more agile and active.
• Athletes: Children who play sports that involve jumping (e.g., basketball, gymnastics, skiing, volleyball) are at increased risk, as are children who play contact sports like football and hockey.
• Physically active kids: In addition to school sports, these accidents can also happen to children who engage in activities such as skateboarding, hiking, and cycling.

What are the possible complications of a fractured growth plate?

Most of the time, if diagnosed and treated promptly (within a week of the injury), these growth plate fractures do not cause major complications. However, sometimes the following can occur:

• Malunion: The fractured bone fragments do not fit together properly, but rather fuse together.
• Nonunion: The failure of the broken bone fragments to heal properly, or not at all.
• Stunted growth: This is very rare . However, if you have a severe fracture (especially Type 5), it can affect the future growth of that bone. This means that the bone may be shorter or smaller than the other side. Surgery may be needed to prevent this.

That's why it's important to see a doctor even if you have the slightest doubt .

How is a growth plate fracture diagnosed?

A doctor diagnoses this type of fracture by examining the child (physical exam) and performing special tests (imaging tests).

First, the doctor will carefully examine the injured area, ask the child about their symptoms, check the range of motion of the limb, and compare it to the other arm/leg that was not injured.

It is very important to tell the doctor all the details you know – what the child was doing before the accident, when you first realized there was a problem, and when the child started feeling pain.

What kind of tests are done?

The doctor will use one or more of these tests to look at the bones and surrounding tissues:

• X-rays: This is the most commonly used.
• Magnetic Resonance Imaging (MRI): Sometimes this is needed to see the exact growth plate.
• Computed Tomography (CT) scans: This is also used in some complex cases.

How are growth plate fractures treated?

Most fractures of the growth plate are treated with a cast, which is a plaster cast (immobilization). The cast keeps the broken bone in place and helps it heal properly. Your doctor will tell you what kind of cast your child needs and how to care for it.

Is surgery necessary?

Surgery is rarely necessary for this type of fracture. Surgery is usually needed for more severe fractures (Type 3, 4, or 5). If your child needs surgery, the surgeon will perform something called internal fixation . This means that the broken bone pieces are set in place and then they will use screws, pins, or wires to hold the bone together from the inside until it heals. After the bone heals, you may need to have another minor operation to remove the pins or wires. Your doctor or surgeon will explain all of this to you.

How long does it usually take to heal?

Most children will need to wear a cast for about a month (four to six weeks) after a growth plate fracture. If the fracture is more severe or if surgery has been performed, it may take longer.

Your doctor can tell you exactly how long it will take to heal, depending on which bone your child broke and how severe the break was.

Can this type of growth plate fracture be prevented?

In fact, most of these fractures are caused by accidents, so it's difficult to completely prevent them. However, there are things you can do to reduce the risk of your child being injured:

When playing sports or engaging in other physical activities, be aware of these things:

• Make sure you are wearing the proper protective equipment (e.g. pads, helmets when playing cricket).
• If something hurts, whether while playing or after you're done, tell your child not to "play through the pain."
• Give your body rest and recover after strenuous activity.
• Stretch and warm up before playing sports or exercising.
• Cool down and stretch when you finish your activity.

Follow these general tips to keep everyone in the family safe:

• Wear a seatbelt whenever you are in a vehicle.
• Check to see if there are any items left in the doorway that could cause someone to slip and fall, and remove them.
• When lifting something from the ceiling , use appropriate equipment (e.g., a ladder). Never let children climb on chairs or tables.

What should I expect if my child has a growth plate fracture?

Most growth plate fractures heal well without any complications or long-term effects on the child's health and development. The best way to reduce the risk of complications is to get a diagnosis as soon as possible (within a week of the injury).

Ask your doctor when your child can start playing, running, and jumping again. If you put pressure on the growth plate again before it has fully healed, there is a higher chance of complications (including re-rupturing the same area).

When should I see a doctor?

If your child has a traumatic event, such as a hard fall or car accident , see a doctor immediately.

If you think your child has a broken bone, or if they have any of the following symptoms , go to the Emergency Department (ETU) immediately:

• Severe pain.
• Inability to move a part of the body.
• A part of the body appears to have changed appearance, stretched, or moved out of place .
• The skin is pierced and the bone is visible.
• Severe swelling.
• These symptoms may be accompanied by new bruising or changes in skin color .

What questions should I ask the doctor?

• Does my child have a growth plate fracture or another injury?
• What type of growth plate fracture does he have?
• Will my child need surgery?
• How long will my child have to wear a cast?
• When will my child be able to return to normal activities and sports?

It's normal to feel scared when a child has an accident, especially if it's a fall or an accident that you couldn't prevent. Although growth plate fractures can be quite serious, most children recover well and are able to do their jobs again.

Time is of the essence when treating a growth plate fracture. If you think your child has a growth plate fracture (or any other bone injury), see a doctor as soon as possible. The sooner the doctor diagnoses the condition and puts a cast on your child, the sooner he or she will be able to recover and return to their normal activities.

Summary (Take-Home Message)

Finally, children's growth plates are a very important part of their bone development. Although injuries to these, namely growth plate fractures, are common, there is nothing to worry about. The most important thing is to seek medical advice as soon as you suspect an injury or notice symptoms. Prompt treatment can help your child recover without harming their future development. Always being mindful of your child's safety will also help minimize accidents.

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