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What is growth plate fracture treatment?

The growth plate is the area of growing tissue near the ends of a child’s long bones. Because the growth plate hasn’t yet hardened into bone, it is more prone to injury than the rest of the bone. Left untreated, a growth plate fracture can interfere with the bone’s normal growth and result in a misshapen or shortened limb. Fortunately, with prompt medical attention, growth plate fractures generally heal without complications.

There are a variety of treatments for a growth plate fracture. The most appropriate approach for a child’s fracture will depend on a number of factors, including which bone was injured, the type of fracture, whether the ends of the bones are out of alignment (displaced) and the patient’s age and medical history. 

Types of growth plate fracture fixation

Nonsurgical treatment

Casting

For many growth plate fractures, immobilizing the bone is enough to allow it to heal on its own. This involves placing a cast on the affected area and limiting activity. Once the cast is removed, working with a physical therapist can help your child regain range of motion in the joint or area where the bone was broken.

Closed reduction

If the fracture has caused the growth plate to separate, or if it has left the bones out of alignment, the doctor may use his or her hands to apply pressure to the area to realign the bones. A local anesthetic will numb the area; your doctor may also recommend sedation to help your child sleep through the procedure.

Surgery

A growth plate fracture may require surgery if bone fragments are out of alignment or not stable. The procedure most often used in such cases is open reduction and internal fixation. The surgeon will reposition the bones to re-establish proper alignment, and then secure them using screws or wires. A metal plate may also be attached to the outer surface of the bone. A cast may be applied to immobilize the limb after surgery.

What to expect

Because a growth plate fracture can cause significant pain and stunt bone development, it is important to seek prompt medical attention if you suspect your child might have sustained a growth plate injury. The doctor will ask questions about the injury and your child’s medical history and perform a careful physical exam. Your child may also need one or more of the following imaging tests:

  • X-ray—Your doctor is likely to order an X-ray; this will provide a clear image of the bone though not of the growth plate, which consists of cartilage. Certain signs may indicate damage to the growth plate, however. The exam will also allow the doctor to identify any other damage to the bone that may be causing pain. The doctor may also request an X-ray of the injured limb and its opposite in order to compare the two.
  • Computed tomography scan (CT or CAT scan)— A CT scan may be ordered if your doctor needs more information. This test uses a computer to combine X-ray images taken from multiple angles, producing a cross-sectional picture that offers great detail. There may be signs on a CT scan if an injury is causing the growth plate to prematurely harden into bone. A CT scan may also allow the doctor to visualize small fractures in the bone that may be responsible for your child’s pain. .
  • Magnetic resonance imaging (MRI)—An MRI uses a strong magnetic field and radio waves to produce images of material that can’t be well visualized on X-ray. It may allow the doctor to identify areas of the growth plate that are prematurely hardening. Lying inside an MRI machine for the exam makes some people feel claustrophobic. Your medical team can talk with you about how to make your child comfortable with the procedure.

Recovery

Depending on the severity of the fracture and the treatment approach, it may take several weeks to a few months for complete healing. Your doctor may recommend regular X-rays for several years after the procedure to confirm that bone growth at the site of the injury is normal.

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