Growth Plate Fracture Treatment | Growth Fracture Surgery

All About the Growth Plate Fracture

Bones, like many other parts of the body, still need to be developed from infancy to adulthood. They do not readily become the hard body support that they already are in the body of adults. From infancy, these bones will collect calcium phosphate. Thus, it is best to take in more foods that are good sources of this mineral that can make the bones strong and dense. Strong bones will be an asset in the way they lend support and strength to the entire body. In infants and children, a growth plate would be in place of the long bones in adult. Before bones are fully developed, they start out as growth plates first. This is also called as physis or epiphyseal plate. This can be found on both ends of every long bone as growing tissues. A bone has two growth plates for each tip. The development of the bones is also determined by these particular plates. When the development of the long bones is complete, the growth plate would retire by closing itself down. The tips of the long bone where the soft tissues of the plate have be replaced by a solid bone.

A simple blow or a light fall will not get a crack or break on calcium dense bones as well. However, extreme force can cause a bone fracture, a condition wherein the bone would sustain a crack or break. This could happen during a heavy fall from a distant height or from an accident that has made a strong impact on the body. There are several types of fractures in the bones, such as Galeazzi fracture which affects the bone on the forearms; intertrochanteric fracture which is a break in the hip bone; glenoid fracture which is a shoulder injury; insufficiency fracture which is caused by stressed bones; and many others. The classification of these fractures is usually based on the name of the injured bone, location of the fracture, or the name of the discoverer or the person who studied the injury. These different classifications are helpful in a way that they help determine a certain condition and the treatment that it will respond to. Another type of fracture would be growth plate fracture.

Usual Victims of Growth Plate Fractures

Children and adolescents still have growth plates. Thus, they are the usual patients of growth fracture. The plates are prone to fracture injury because they are still weak, with their lack of calcium phosphate. Normally, a bone would have been stronger than the tendons and the ligaments surrounding it. However, a growth plate is even weaker than these two. Thus, upon strong impact, the plates might crack or break but the tendons and ligaments might stay unharmed after the accident. While the plates are still developing, they are really vulnerable to growth plate injuries. Growing children and adolescents would likely have growth bone fracture in as much as adults are prone to having sprain.

A growth plate injury is already considered a fracture. This type of injury accounts for about 15 percent of all the fractures that are encountered by children.  Girls aged 11 to 13 years old and boys aged 14 to 16 years old are the more specific common patients of fracture growth plate. There is a noticeable difference in the age demographics between the girls and the boys because the growth plates in girls are replaced much earlier with solid bones than boys. While 14-year old girls are slowly developing their growth plate into a solid bone, 16-year old boys are still prone to having fractured growth plate.

Among the cases of growth plate fracture in children and adolescents, 50 percent accounts for fractures of wrist, particularly on the lower part of the forearm’s outer bone. Broken growth plate would happen to tibia and fibula, the lower bones found in the leg, and the femur, foot, ankle, or hip bone. Thus, growth plate fracture ankle might happen.

Causes of Fracture in Growth Plate

Accidents, a strong blow, or a fall are pointed out as the usual causes of this growth plate bone fracture. This is caused mostly by falling. Since they love to play and run, a fall is not something unexpected. A single wrong step would have a child stumbling and falling on the floor or on the playground. Giving a child the wrong playing equipment that is too heavy or too big to manage might result to shoulder growth plate fracture. There are different types of growth plate fracture based on where they happen to be. One can have a fractured ankle growth plate, hip growth plate, foot growth plate, tibial growth plate, elbow growth plate, and more. This is because there are also several activities that could result to the previously mentioned injuries. Active and sporty adolescents who love basketball, softball, football, dancing, gymnastics, and track and field sports might experience ankle growth plate fracture, especially when these contact sports involve lots of running. Contact sports account for one-third of the causes of this growth plate injury on the growth plate. Other physical and entertaining activities, such as skateboarding, biking, skiing, sledding, and the like, account for one-fifth of the identified causes that trigger the fracture of growth plate. Some causes of this injury are vehicular accidents. They comprise only a small percentage of the reasons why kids have fractured growth plate in ankle, foot, wrist, hip, elbow, and other body parts.

Parents should be responsible in watching over their kids. When they complain about some painful parts of their body after an injury or an accident, they should be rushed to the doctor for the possibility of growth plate fractures. In some cases, growth fracture treatment should be urgently applied. An open fractured growth plate should be rushed for emergency treatment in order to avoid the risk of infection.

Fracture Symptoms of Emergency Cases

Some cases of fractured growth plate are more urgent than others. These would include:

• Visible bending or deformity of the elbow growth plate fracture, or the injured part
• Extreme pain that keeps the kids from playing or moving normally
• Less time for playing due bothersome pain that is felt after an accident that result to an injury
• Severe pain that restricts the arms or legs from moving
• Fracture Diagnosis of Growth Plate Injuries

Several diagnostic tests have to be performed in order for the doctor to know how to treat growth plate fracture. The x-ray test is the most common examination that is done for most patients, as per the initial findings of the doctor. However, a little problem in the diagnosis would be the fact that the growth plates will not make an appearance on the x-ray film. Instead, gaps will appear in the place of the plates. For diagnosis, the doctor still has to compare the film of the injured plate with that of the uninjured one. An MRI scan, ultrasound, and CT scan are also necessary to locate all the fractured epiphyseal plates and to know exactly how to heal them in the most effective way. A tibial growth plate fracture would be diagnosed this way, as do the other types of growth plate injuries.

Treatment of Growth Plate Injuries

A growth plate fracture in foot, hip, wrist, or elbow should be examined and treated by an orthopedic surgeon. This is a specialist surgeon who treats bone problems. The best time to start the treatment for fractured ankle growth plate, or similar fracture, should be right after the injury. This also goes the same for growth plate wrist fracture. After diagnosis, the doctor might recommend any of the following as treatment for fractured growth plate in foot, hip, wrist, or elbow:

• Immobilization. This can be administered with the use of a brace or braces. Its function is to keep the injured bone from moving for the healing to be smooth and for the fracture healing time to be quick. Recovery time for other fractures sometimes last for months. A fracture cast is also an alternative.
• Manipulation or Fracture Surgery. This requires putting the bones back together in the process called manipulation. Open reduction and internal fixation (ORIF) is a surgical option that is commonly used for patients with severe epiphyseal plate injuries.
• Stretching and Strengthening Exercises. These exercise routines work as rehab for the bones. Rehabilitation is necessary to get the healing bones used to working again. However, it may take a few weeks for complete growth plate fracture healing time.