Growth Plate Injuries: Causes, Symptoms, & Treatment Options

Updated 12/14/2023
Growth Plate Injuries, University Foot and Ankle Institute

What are Growth Plates?

Growth plates, also known as epiphyseal plates, are soft points on the end of a child's bone that form solid bone as your child matures. Growing bones each have one growth plate at either end. 

 

A suspected injury to the growth plate needs to be evaluated by a specialist right away. An injury to a growth plate can cause it to harden and “close” prematurely, meaning it stops producing new bone before your child is done growing. If left untreated, a growth plate injury could stunt bone growth.

How common are growth plate injuries? 

The growth plate is actually more vulnerable to injury than the surrounding tendons and ligaments. An injury that might cause a joint sprain in an adult can cause a growth plate fracture in a child.

 

About 15% of fractures in adolescents are growth plate injuries. 

 

How do growth plate fractures of the foot occur? 

Most growth plate injuries result from acute trauma, such as a fall, car accident, or twisted ankle. They’re more common in younger children and teens who participate in competitive sports such as gymnastics or in recreational sports such as skateboarding, sledding, and biking. 

 

However, some injuries are caused by overuse and repetitive stress to the joint.

 

In addition to acute injuries, growth plates can be damaged by other events, such as a bone infection, frostbite, or radiation therapy cancer treatment. Children who have neurological or musculoskeletal disorders that affect their growth are also more prone to growth plate injuries.

 

What are the symptoms of a fractured growth plate?

Your child or teen may have a growth plate injury if they:

 

  • Have sustained an acute injury to one of their limbs.
  • Complain of severe pain as a result of an injury.
  • Can no longer play or have a worsening ability to play recreational activities after sustaining an injury.
  • Have a visible deformity in the injured area.
  • Complain of persistent pain and soreness at a joint or in the heel, especially if they are very physically active.
  • Injuries to the growth plate can be difficult to catch. In adults, an X-ray can easily detect a fracture, but recognizing a growth plate fracture in children takes a specially trained eye.

 

How can the podiatrists at University Foot & Ankle Institute diagnose your child's growth plate injury? 

 

Our foot and ankle specialists can check for a growth plate injury or bone fracture by conducting a physical examination. While there may not appear to be a fracture, we can also diagnose a growth plate injury by comparing an X-ray image of the injured limb and an image of the healthy opposite limb. An MRI (magnetic resonance imaging), CT scan (computed tomography), or ultrasound can also aid in the diagnosis of growth plate injuries.

 

What are the common types of growth plate fractures? 

Type I: Type 1 fractures (also known as Salter-Harris fractures) often occur in younger children. The injury goes across the growth plate and surrounding bones are not affected. They are likely to appear normal on an X-ray and can be treated with a cast. Healing is often fast and complication-free.

 

Type II: This type of fracture goes across the growth plate and up the shaft of the bone. Type II fractures are common and often affect older children. The broken bone often needs to be repositioned.

 

Type III: This fracture goes across the growth plate through the end of the bone and into the adjacent joint. These injuries usually affect older children and may involve cartilage damage. Proper positioning of the broken bone is extremely important following this type of fracture. 

 

Type IV: These fractures go across the growth plate and through the joint cartilage. Type IV fractures may involve joint cartilage and impair growth. Proper positioning is also extremely important and surgery can be required to hold the bones in the proper position.

 

Type V: In this type of fracture, the growth plate is crushed. Because bone alignment and length can be affected, type V growth plate fractures are the most concerning. Unless the growth plate is aligned perfectly and maintained during recovery, the prognosis for growth is poor.

 

What are the treatments for a growth plate foot fracture? 

If there’s a chance your child or teen has injured a growth plate, make an appointment with our foot and ankle specialists. Proper treatment is critical and under no circumstances should your child keep running or playing while injured. 

 

Many young athletes try to minimize their injury or “play through the pain,” but if teens and children do not give their growing bodies time to heal, they may be setting themselves up for a more serious condition in the future.

 

Depending on the type of fracture and severity of the injury, we may recommend one of these courses of treatment.

 

  • Immobilization. The joint will typically be immobilized in a cast or splint for two to four weeks to give the area time to heal. In the meantime, your child should limit their physical activities and refrain from bearing weight on the injured foot.
  • Manipulation. In some cases, the doctor can manipulate the joint by hand to place the bones back into their correct position. Afterward, the joint will be set in a cast for two to four weeks until it has healed completely.
  • Surgery. For severe growth plate fractures, a surgical correction may be required. The surgical site will then be placed in a cast or boot for four to six weeks while the soft tissues and bone heal.

 

Recovering from a growth plate fracture 

After the growth plate fracture has healed, our physical therapists will recommend exercises to strengthen the muscles and improve the joint’s range of motion. The greatest risk of a growth plate injury is the stunted growth of the bone (also known as growth arrest), and the younger your child is at the time of the injury, the greater the risk of severe stunting.

 

Your child’s doctor will schedule follow-up visits, including physical exams and X-rays, about two to three times per year for two years after successful treatment.

 

Choose UFAI for the best pediatric podiatrists 

Our nationally recognized team of foot and ankle experts has been providing advanced, comprehensive, and compassionate care to pediatric patients for over 20 years. They understand the unique circumstances involving the treatment of children and their developing and growing bones, joints, and tendons.

 

To schedule a consultation, please call (855) 872-5249 or make an appointment online

 

University Foot and Ankle Institute is conveniently located throughout Southern California and the Los Angeles area. Our foot doctors are available at locations in or near Santa Monica, Beverly Hills, West Los Angeles, El Segundo, Northridge, Downtown Los Angeles, Westlake Village, Santa Barbara, and Valencia.

 

 

growth plate injury faqs

 

Growth plate injury FAQs

 

Can adults suffer growth plate injuries?

Yes, adults can suffer growth plate injuries, although it is relatively uncommon. As we age, growth plates typically close by the early to mid-20s. However, in some cases, growth plates may remain susceptible to injury. 

 

Can you play soccer on a growth plate ankle injury?

Playing soccer or engaging in other high-impact sports with a growth plate injury can be risky and may exacerbate the injury. Growth plates are areas of developing cartilage, and they are more vulnerable to injury, especially in younger individuals. Continuing to put stress on the injured area can lead to complications or long-term issues. It's especially important to consult with a healthcare provider. 

 

Does growth plate injury affect height?

Yes, a growth plate injury can potentially affect a person's height, especially if the injury occurs in a growth plate that is actively contributing to bone growth. The extent to which a growth plate injury affects height depends on age, severity and location of the injury and the treatment provided.

 

How to prevent growth plate injuries?

Here are some tips on how to prevent growth plate injuries:

  • Safety Gear: Ensure that young athletes wear appropriate safety gear for sports and activities to reduce the risk of injuries.
  • Proper Coaching: Enroll children and adolescents in sports programs or activities with qualified coaches who emphasize proper technique and safety.
  • Warm-Up and Stretching: Proper warm-up helps prepare the muscles, tendons, and ligaments for physical exertion, reducing the risk of injury.
  • Age-Appropriate Activities: Some activities may be more suitable for specific age groups based on their physical development and maturity.
  • Rest and Recovery: Allow children and adolescents to have adequate rest and recovery periods between training sessions and competitions. Overuse injuries can be a concern, so it's essential to avoid excessive training and repetitive stress on the body.
  • Balanced Nutrition: Adequate calcium and vitamin D intake is essential for strong bones.
  • Hydration: Ensure proper hydration during physical activities. Dehydration can affect performance and increase the risk of injuries.
  • Monitoring Growth: Regularly monitor the growth and development of children and adolescents, as growth plate injuries are more common during growth spurts.
  • Avoid Overtraining: Avoid pushing children or adolescents too hard in their athletic pursuits. Overtraining can lead to fatigue and increase the risk of injuries, including growth plate injuries.
  • Injury Reporting: Encourage open communication between children and their coaches or parents regarding any pain, discomfort, or injuries. Promptly address any signs of injury to prevent further complications

 

How long does a growth plate injury take to heal?

The time it takes for a growth plate injury to heal can vary significantly depending on several factors, including the severity of the injury, the specific growth plate affected, the age of the individual, and the treatment provided. Generally, healing of growth plate injuries can take several weeks to several months. 

 

Sources 

Growth plate fractures. American Academy of Orthopaedic Surgeons. http://orthoinfo.aaos.org/topic.cfm?topic=A00040. Accessed March 29, 2016.

 

Stracciolini A, Casciano R, Levey Friedman H, Stein CJ, Meehan WP 3rd, Micheli LJ. Pediatric sports injuries: a comparison of males versus females. Am J Sports Med. 2014 Apr. 42 (4):965-72. [QxMD MEDLINE Link]

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