Causes and risk factors
Growth plate fractures commonly occur during sport events like gymnastics, football, running, basketball, skateboarding, skiing, etc. It may occur during car accidents or a fall or trauma to the limb. Younger boys of age 14-16 are more at risk for these fractures than girls, as girls mature sooner than boys hence in turn complete their growing process before them too.
Clinical presentation:
Depending upon the location of the fracture, growth plate fractures are divided into four types- Type I, II, III, IV, and V. Type I is characterized by breaking of bone which causes separation of the growth end from the shaft. In type II, some part of the growth plate is broken and the shaft is cracked. In type III, a cross portion of the growth plate is broken into pieces. While in part IV, the fracture breaks the growth plate, end of the bones, and the shaft. Type V is characterized by crushing of the bones. Pain at the affected site along with tenderness. Visible deformity of the affected leg or hand, inability to move the affected region are seen. Restriction of movements occur. Usually these growth fractures heal without any complications, but at times if the injury has been severe, it may lead to a bone deformity, crooked bone and unequal length, and stunted growth, that is, arrest of the bone growth at an early age itself.
Investigations:
Diagnosis is done on the basis of the symptoms narrated by the patient and the physical examination is carried out by the orthopedic doctor. X-ray of the affected joint as well as the non affected one is done to compare both to assess and understand the case better as the bones of these children haven’t yet hardened completely and hence are difficult to interpret them. MRI or CT scan can be done to know the extent of injury and involvement of the surrounding structures.
Treatment:
Rest and restriction of movement need to be adopted. Splint or cast application is suggested. Medication for relieving pain is advised. The treatment is decided depending upon the severity and intensity of the injury occurred.
In severe cases, surgical intervention is needed. It comprises of open reduction and internal fixation. Repeated x-rays are advised for an interval of every 3-6 months for at least two years as the child’s growth needs to be monitored to avoid any restriction in the maturing or growth of the bone.
