What is a growth plate fracture, who's at risk for this injury, and how is it treated? Well, this is an injury that only affects children. And that's because it involves a growth plate, a soft area of still-developing cartilage that exists at the end of children's bones. It's an injury best diagnosed and treated by our pediatric podiatrist here in Houston, TX. 

What are growth plates and where are they located? 

As we mentioned, growth plates are areas of tissue located near the ends of kids and teens' long bones. (That includes the thigh bone, as well as bones in the forearm, hands and fingers.)  Each end of these long bones is bracketed by growth plate tissue that turns into solid bone once your child stops growing. 

During the growing years, these plates are vulnerable to injury because they are so soft. In some cases, that can translate to conditions such as Sever's disease. (When the growth plate in your child's heel, at the end of the femur bone, develops inflammation.) But in other cases, when your child breaks a bone that passes through a growth plate, he or she may also develop a growth plate fracture. 

What is a growth plate fracture? An illustration of Severs Disease highlight growth plate location

This injury describes a break in a bone that passes through a growth plate. Ranging from a minor to a very serious injury, this form of fracture can cause several distinct symptoms in your child. While any injury could cause damage to this delicate tissue, the most common causes are playground falls and sports-related injuries. 

Boys are more likely to injure their growth plates than girls. And that's because girls' bodies mature at a faster rate. This means their bones harder sooner. And they are less vulnerable to growth plate injuries as they become more active.  

Additionally, children who play competitive sports are more vulnerable to growth plate fractures. Sports that pose a particular risk include

  • Football
  • Basketball
  • Gymnastics
  • Biking

In some cases, growth plate injuries are caused by repetitive use, although that will more often result in inflammation than in a fracture. 

Signs and Symptoms

Your child's symptoms will vary depending on the severity of the injury and the area affected. However, if you notice swelling or pain, a change in the shape of your child's injured limb, warmth, redness or bruising, or difficulty moving or using the affected area, it's important to come into the office right away. An untreated growth plate fracture could impact your child's bone growth during their critical developmental years. 

Diagnosing and Treating a Growth Plate Fracture

After a physical exam, we can diagnose the fracture using our in-office X-ray in Houston. The images will also help us know how severe of an injury your child is dealing with, based on the Salter-Harris classification system. 

A type I injury would mean the fracture passed through the growth plate, but the surrounding bone isn't involved. 
Type II injuries, the most common, mean the fracture passes through the growth plate and the area between the growth plate and bone shaft. 
Type III, Type IV and Type V fractures are less common and involve the growth plate, space between bone and plate, and the shaft of the long bone. 
Once we know the severity of the injury, we'll determine the best treatment plan.  

Non-surgical Treatments

When the fracture is minor, and not displaced, we can immobilize the injury for healing. For most kids, that will mean spending four to six weeks in a cast or walking boot to allow for a full recovery. However, if the fracture is displaced (the broken plate is not aligned) the bone will have to be reset. Afterward, your child will need a cast and may need physical therapy or even a hospital stay. 
 

When is Surgery Necessary?

If your child's fracture is unstable (a cast alone can't hold the injured bone in place) surgery may be necessary. If that is the case, we'll talk you through the process and guide your family through the procedure and recovery period. 

Recovery and Beyond 

If not treated properly, any injury to your child's growth plate could affect the angle at which bones grow, along with overall height. Additionally, when the femur's growth plates are impacted, your child could end up with a leg-length discrepancy. (When one leg is longer than the other. This condition can result in pain and changes in gait. But we can treat it in our office with custom orthotics.) 

Luckily, with early diagnosis and treatment, we can usually prevent these outcomes. However, even after the injury heals, we'll need to monitor your child for several months in order to make sure normal bone growth has resumed. For older children, a growth plate fracture is not usually concerning, since most growth is already complete. But for younger children, who still have lots of growth ahead of them, careful monitoring will be critical. 

Why a Pediatric Podiatrist Should Treat Growth Plate Injuries of the Foot

Here at our pediatric podiatry practice, we know that foot pain in kids is never normal. And, because all podiatrists do is take care of feet, we can detect sign of an injury that other doctors may miss. What does that look like? 

While some kids injury symptoms may be obvious, other children may display more subtle signs that something is wrong with their feet or ankles. Especially in younger children, something as simple as sitting down and refusing to walk could be a sign of foot pain, not stubbornness. 

Why else should you see a podiatrist when your child's foo, toe or ankle may be broken? Well, we offer X-rays in our office. That means you can skip the ER. And the hours-long waits. 

Do you suspect that your child has suffered a growth plate fracture? Are you unsure if an injury has occurred, and you're waiting to see how things go? Don't wait another day! Kids feet and ankles should never experience discomfort. It's not a normal part of development. So, if your child is complaining of any foot, toe or ankle pain, schedule an immediate appointment in the office. When you come in, we'll determine the cause of your child's pain, and get him or her back to moving in comfort.