The bones of children and adults share many of the same risks for injuries, however, because children are still growing, a child’s bones are subject to growth plate fractures. Growth plates are areas of cartilage located near the ends of bones. Because they are the last portion of a child’s bones to harden, growth plates are extremely vulnerable to fracture.
Anatomy
Growth plates are found in the long bones of the body including the femur, the radius, the ulna, and the metacarpal bones in the hands. Because bone growth occurs at each end of the bone, rather than in the center, most of the long bones have at least two growth plates – one at each end. When a child is fully grown, the growth plates harden into solid bone.
Fractures
Growth plate fractures can be broken down within several classification systems, one of them being the Salter-Harris system. This is system is described below.
- Type I Fractures: These fractures break through the bone at the growth plate, separating the bone end from the bone shaft and completely disrupting the growth plate.
- Type II Fractures: These fractures break through part of the bone at the growth plate and crack through the bone shaft as well. This is the most common type of growth plate fracture.
- Type III Fractures: These fractures cross through a portion of the growth plate and break off a piece of the bone end. This type of fracture is more common in older children.
- Type IV Fractures: These fractures break through the bone shaft, the growth plate, and the end of the bone.
- Type V Fractures: These fractures occur due to a crushing injury to the growth plate from a compression force. They are rare fractures.
Treatment
Treatment for growth plate fractures depends on several factors, including:
- Which bone is injured
- The type of fracture
- How much the broken ends of the bone are out of alignment (displaced)
- The age and health of the child
- Any associated injuries
Nonsurgical Treatment: Many growth plate fractures can heal successfully when treated with immobilization. A cast is applied to the injured area and the child limits some types of activity. Dr. Hicken uses cast immobilization when the broken fragments of bone are not significantly out of place. A cast will protect the bones and hold them in the proper position while they heal.
Surgical Treatment: If the bone fragments are displaced and the fracture is unstable, surgery may be necessary. The most common operation used to treat fractures is called open reduction and internal fixation. During the procedure, the fragments are repositioned into their normal alignment and then fixed into place with implants like screws or wires. A cast is then applied to protect the area while it heals.
Because a child’s bones heal quickly, a potential growth plate injury should be examined by a doctor as quickly as possible, ideally within 5 to 7 days. It is important that the bone receives the proper treatment before it begins to heal. If you believe your child has experienced a growth plate fracture, give Dr. Hicken a call at 435-787-2000.
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