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Growth plate injuries: Answers from a pediatric orthopaedic surgeon

Growth plate injuries: Answers from a pediatric orthopaedic surgeon

Fractures are common in children. However, because a child’s bones are subject to a unique injury called a growth plate fracture, it is important that broken bones in kids be treated properly. According to the American Academy of Orthopaedic Surgeons, approximately 15 to 30 percent of all childhood fractures are growth plate fractures.

In the following Q&A, Bryan Tompkins, M.D., one of three board-certified pediatric orthopaedic surgeons at Shriners Hospitals for Children — Spokane, addresses questions about growth plate injuries.

What are growth plates?

Growth plates are areas of active, new bone growth near the ends of bones, made up of cartilage that hardens once a child is fully developed. Growth plates help determine the eventual length and shape of the adult bone. They are the last portion of bones to harden, making them vulnerable to fracture. In fact, because muscles and bones develop at different speeds, a child's bones may actually be weaker than the ligament tissues that connect the bones to other bones.

What kind of doctor treats growth plate fractures? Are they urgent?

A child with a bone injury should see an experienced pediatric orthopaedic specialist as soon as possible. Children’s bones heal faster than adult’s, so the injury needs to be treated promptly to avoid improper healing and potentially crooked or unequal length limbs.

How are growth plate injuries treated?

Growth plate treatment depends on the severity of the injury and will generally involve a combination of the following:

  • Manipulation or surgery
  • Splinting or casting
  • Physical therapy
  • Long-term observation

How are growth plate fractures diagnosed?

Usually, an X-ray is adequate for diagnosing the fracture. For complex injuries or those difficult to see on an X-ray, more advanced imaging, such as magnetic resonance imaging (MRI) or computed tomography (CT), may be required.

Will the affected limb still grow?

If treated correctly, most growth plate fractures will heal without any lasting effect. However, the healing process depends on factors such as severity of the fracture, the age of the child and which growth plate is injured – for instance, growth plates at the knee have a greater risk of complications.

Spokane and surrounding communities have access to the region’s only fellowship-trained pediatric orthopaedic surgeons, at Shriners Hospitals for Children — Spokane.

Symptoms/signs that indicate a visit to the doctor is advised

  • Inability to continue play because of pain following an acute or sudden injury
  • Decreased ability to play over the long term because of persistent pain following a previous injury
  • Visible malformation of the child’s arms or legs
  • Severe pain from acute injuries that prevent the use of an arm or leg

Photo: Bryan Tompkins, M.D. One of Dr. Tompkins’ specialties is sports injuries in children and adolescents. He has been a surgeon at the Spokane Shriners Hospital since 2007.