What to Know If Your Child Has a Fracture of the Growth Plate

A growth plate is a section of tissue near the end of the body’s long bones. Long bones are any bones that are longer than they are wide. They include bones in the arms, legs, and fingers. Growth plates are at either end of many long bones.

Throughout a person’s childhood and teenage years, growth plates are soft and allow bone growth. Growth plate tissue hardens into solid bone once a child finishes growing.

Growth plates are the softest parts of the skeleton for children and teens. The tissue can fracture due to injury or overuse. Since growth plates are softer than bones, even injuries that seem mild could cause growth plate fractures. Fractures can happen on any growth plate, but it’s most common for kids to fracture the growth plates on their:

• fingers
• lower leg bones
• outer forearm bones

It’s important to schedule an appointment with a doctor if you suspect your child has a growth plate fracture. Symptoms can depend on the severity and location of the future but often include:

• soreness around the injury
• tenderness when touching the area
• swelling near a joint
• difficulty moving, putting weight on the limb, and doing recreational activities
• repeated complaints of pain
• visible changes in arm or leg form

Experts classify growth plate fractures according to the Salter-Harris system. This system groups fractures by the severity and nature of the break and helps doctors with discussion and treatment. A description of the system is below.

• Type I fractures: A type I fracture breaks the bone at the growth plate, separating the growth plate and bone from the bone shaft.
• Type II fractures: A type II fracture breaks through the bone at the growth plate and cracks the bone shaft. Type II fractures are the most common types of growth plate fractures.
• Type III fractures: In a type III fracture, there is a break that involves a fracture across the growth plate and a broken part of the main bone. Older children are more likely to experience type III fractures.
• Type IV fractures: A type IV fracture involves a fracture through the growth plate, bone shaft, and the end of the bone.
• Type V fractures: A type V fracture happens when an extreme force crushes the growth plate and bone.

Injury or overuse can cause growth plate fractures. Common causes of growth plate fractures in children include:

• falls
• accidents while biking or doing other outdoor activities
• car accidents
• sports injuries, including from gymnastics, dance, overtraining

A doctor will assess your child’s symptoms and medical history. They’ll do a physical exam to look for swelling and tenderness. If the doctor suspects a growth plate injury, they’ll order imaging tests.

In many cases, an X-ray can provide clear pictures of the bone, growth plates, and any fractures. Sometimes, doctors might use additional imaging tests, such as an MRI or CT scan, to get more detailed images.

Growth plate fracture treatment can vary and depends on factors such as the type and location of the fracture and the age and overall health of the child. Common treatment options are below.

• Immobilization: Applying a cast to the injured area and limiting activities until it heals is often the primary treatment. Immobilization allows growth plates to stay in position while they heal. The timeline for immobilization depends on the severity of the fracture.
• Surgery: Doctors perform surgery when they don’t think bones will heal correctly on their own. Surgical procedures can realign bones and secure them into place with medical screws or wires.
• Observation: In some cases, it can be difficult to tell how much damage occurs due to a growth plate fracture. When this happens, doctors often order regular X-rays for children following initial treatment to ensure their bones grow correctly. This observation phase can last years.

Children can experience a growth plate fracture from both minor and serious accidents. Overuses during athletics can also result in growth plate fractures. Some children have an increased risk of growth plate fractures, including children and teens who:

• train for gymnastics, baseball, basketball, or any other sport at a high level
• engage in skiing, snowboarding, horseback riding, or other hobbies that carry a risk of injury
• inherit medical conditions that weaken their bones
• develop bone infections
• live in extreme or abusive conditions

Additionally, growth plates harden and seal at different times, depending on factors such as genetics and sex assigned at birth. Typically, females finish growing several years before males. This means that in many cases, males have open growth plates for much longer than females. This puts them at an increased risk of growth plate injuries.

Many growth plate fractures heal without long-term complications. However, it’s possible for growth plate fractures to impact future bone growth. They can result in limb form changes, uneven limbs, or reduced height.

Sometimes, surgery can correct these complications, but other times the injury may be permanent. The best way to avoid permanent complications is prompt diagnosis and treatment.

The outlook for growth plate fractures is typically positive. Children and teens can recover from growth plate fractures without lasting complications. Quick diagnosis and appropriate treatment can help prevent the fracture from affecting future bone growth.

For more information about growth bone fractures, you can check out the answers to some common questions below.

Can you prevent growth plate fractures?

There’s no way to predict and prevent all injuries, but there are some steps you can take to help your child reduce their risk. For instance, it’s a good idea to make sure kids wear safety gear, such as knee and elbow pads, during sports and recreational activities.

Additionally, making sure your child doesn’t overuse a limb during athletics can help lower their risk.

How fast do growth plate fractures heal?

Healing time depends on the type and location of the break. However, many growth plate injuries heal in about 6 weeks.

Can adults fracture their growth plates?

Growth plates seal and become usual bone after growing stops. An adult can fracture the section of bone formerly known as the growth plate, but it is not a separate injury from a standard fracture.

A growth plate fracture is an injury to the soft tissue at the end of long bones in children and teens. Fractures can happen as a result of an accident or overuse.

The recovery time and exact treatment depend on the type and location of the fracture. Without treatment, severe fractures can affect bone growth and lead to complications, such as reduced growth and changes in limb formation. However, with treatment, many children can heal from growth plate fractures without any lasting damage.