Growth Plate Fracture occurs when the sensitive regions responsible for bone growth during childhood and adolescence are affected by trauma. Pain, swelling, and limited range of motion around the joint may be observed; in some cases, it can be confused with a sprain. Early diagnosis and appropriate treatment are essential for proper bone healing and preservation of normal growth.
Contents
- What Is a Growth Plate Fracture?
- Where Is the Growth Plate Located and Why Is It Important?
- Why Are Growth Plate Fractures More Common in Children?
- What Causes a Growth Plate Fracture? Common Injury Mechanisms
- Which Bones Are Most Commonly Affected by Growth Plate Fractures?
- Frequently Asked Questions
What Is a Growth Plate Fracture?
A Growth Plate Fracture is a type of fracture seen in childhood and adolescence that affects the growth cartilage located near the ends of bones. Unlike adult bones, children’s bones continue to grow, and a significant part of this growth occurs through the growth plates. Therefore, trauma involving the growth plate does not only mean a broken bone; it also means that a structure responsible for the bone’s lengthening and shaping may be affected. Families often suspect this condition when a child complains of pain around the wrist, ankle, or knee after a fall.
Not every Growth Plate Fracture has the same severity. In some fractures, the growth plate is only mildly affected and heals without problems with proper treatment. In others, the bone ends near the growth plate may shift, or the fracture line may extend into the joint. In such cases, proper alignment during healing and long-term growth monitoring become more critical. The main goals of pediatric orthopedic care are accurate classification of the fracture, appropriate treatment planning, and close monitoring to determine whether the growth plate may cause future problems.
Where Is the Growth Plate Located and Why Is It Important?
The growth plate is a cartilage structure located near the ends of long bones, close to the joints. As children grow, this cartilage tissue gradually transforms into new bone in an organized manner. As long as the growth plates remain active, bones continue to increase in length; once growth is complete at the end of adolescence, these plates close and the adult bone structure forms. For this reason, a Growth Plate Fracture is not only an acute injury but also a condition that may affect future growth.
The importance of the growth plate is not limited to bone lengthening. It also plays a key role in proper bone alignment, joint positioning, and balanced load distribution. If early closure or uneven growth occurs after a growth plate injury, limb length discrepancy or angular deformities may develop.
For this reason, early evaluation and proper follow-up in suspected Growth Plate Fracture cases significantly improve long-term outcomes.
Why Are Growth Plate Fractures More Common in Children?
In children, while ligaments and joint capsules are relatively more flexible, the growth plate may be more vulnerable to trauma due to its cartilage structure. In adults, the same mechanism may cause a sprain or ligament injury; in children, the load may be transmitted more directly to the growth plate, resulting in a Growth Plate Fracture. During rapid growth periods, the bone-cartilage transition zones may become relatively more sensitive. Additionally, children are more frequently exposed to falls, collisions, and sudden directional changes during play and sports activities, increasing the incidence.
During school age, running, jumping, ball games, and contact sports increase; in adolescence, sports intensity and speed rise further. As a result, wrist, ankle, and knee injuries are more common. A critical point regarding Growth Plate Fracture is that even a seemingly simple fall can cause a fracture. Therefore, joint pain in children should not be dismissed as a simple sprain; proper examination is necessary to assess fracture risk.
What Causes a Growth Plate Fracture? Common Injury Mechanisms
Growth Plate Fracture most commonly occurs after a fall. Falling onto an outstretched hand may affect the wrist; twisting of the ankle inward or outward may affect the ankle; direct impact to the knee or sudden stop-and-turn movements may involve the knee growth plate. Skateboard, rollerblade, and bicycle accidents, as well as contact or awkward landings in sports such as football, basketball, and volleyball, are frequent mechanisms. Outside sports, daily incidents such as playground falls, slipping on stairs, or tripping at home may also trigger injury.
In some cases, the trauma may not appear severe; however, due to the structural sensitivity of the growth plate, a fracture may still occur. Particularly around the ankle, mechanisms resembling a sprain can result in a Growth Plate Fracture, leading families to mistakenly assume it is a simple sprain. The severity of pain, degree of swelling, and ability to bear weight do not always reflect the size of the fracture. Therefore, both the mechanism of injury and clinical findings should be evaluated together.
Which Bones Are Most Commonly Affected by Growth Plate Fractures?
Growth Plate Fracture most frequently occurs around the wrist, particularly at the ends of the forearm bones. Falls onto an outstretched hand make this area vulnerable. Around the ankle, the lower ends of the tibia and fibula are also commonly affected; these fractures are frequently seen in athletic children and adolescents. Around the knee, the lower end of the femur and the upper end of the tibia may be involved, and fractures in this region require careful follow-up due to their significant contribution to growth.
Growth plate injuries can also occur in the finger bones, metacarpals, and heel region. The affected area depends on the direction and intensity of the trauma. The child’s age and activity level also influence distribution. The key point is to consider the possibility of a Growth Plate Fracture in any child presenting with joint pain and tenderness.
Frequently Asked Questions
Is Pain Normal While in a Cast After a Growth Plate Fracture?
Pain and throbbing may occur in the first few days and are expected to gradually decrease. If pain increases or there is numbness, coldness, or discoloration in the fingers, urgent evaluation is necessary.
When Can a Child With a Growth Plate Fracture Return to School?
If the child’s general condition is good and pain is under control, returning to school is usually possible within a short time. Crutch use, cast care, and physical education restrictions should follow the physician’s plan.
Is Physical Therapy Necessary After a Growth Plate Fracture?
Not always. It may be recommended if there is significant stiffness, muscle weakness, or difficulty returning to sports after cast removal.
Is a Growth Plate Fracture Always Visible on X-ray?
It may not always be clearly visible. If clinical suspicion is high, follow-up X-rays, additional views, or advanced imaging may be requested.
How Long Does Swelling Last After a Growth Plate Fracture?
In most children, swelling significantly decreases within the first week. Prolonged swelling, redness, warmth, or fever warrants re-evaluation.
What Should Be Done If Pain Recurs in the Same Area After a Growth Plate Fracture?
If pain recurs, increases with weight-bearing, or limping develops, re-examination is necessary. The area should be assessed for growth plate involvement or other potential issues.
