Common Growth Plate Injuries

By Jared Ernest MPT

What is a Growth Plate ?

Growth plates are only found in children and adolescents. It is not uncommon for adolescents to suffer growth plate injuries. So what exactly is a growth plate? They were formally known as epiphyseal plates. Additionally, growth plates are the soft ends of bones that allow the bone to expand and lengthen. These soft bones are located at the growth centers at the end of long bones. These bones typically remain soft till around age 14 in girls and 16 in boys, as they mature they will be replaced with hardened bone after growth stops.

Illustration of the growth plates within the human body. JOI Rehab

Human Growth Plates of the Body

What 3 Bones are most likely to have a Growth Plate Fracture?

  1. Thigh bone (femur)
  2. Fingers
  3. Forearm

What are the causes of Growth Plate Fractures?

Most growth plate fractures are caused by fall or force to a limb such as:

Car accident, contact sports, fall from heights, overuse activities such as little league shoulder that results from excessive pitching, poor physical conditioning that makes bone less protected. Lastly, these are just some of the most common causes for fractures to the growth plates.

Little League pitcher with a repetitive use injury to the shoulder. JOI Rehab

Little League Shoulder

What are the Signs and Symptoms of Growth Plate Fracture?

  • Pain, tenderness and swelling at injury site
  • Not able to use injured area
  • Lack of strength and unable to put any type of pressure on injured area
  • Deformity of bone at injured area

How are Growth Plate Injuries able to be Classified?

The medical community uses the Salter – Harris classification as 5 types. These 5 types are labeled by the higher the number the more severe the fracture.

Type 1:

Fracture through growth plate

Type 2:

Fracture through growth plate and metaphysis

Type 3:

Fracture through growth plate and epiphysis

Type 4:

Fracture through growth plate, epiphysis and metaphysis

Type 5:

Crush injury of growth plate


How is a Growth Plate Fracture Diagnosed?

MD with physical evaluation to assess signs and symptoms. This evaluation could result in the MD ordering imaging tests such as X-Ray, MRI, and CT Scan to assess status of growth plate

How is Growth Plate Fracture treated after a Positive Diagnosis?

  • Medicine typically ibuprofen, Naproxen or acetaminophen
  • Cold such as ice packs 10-15 minutes every 2-3 hours
  • Orthopedic devices such as splints and braces to immobilize
  • Rest to reduce pain and allow bone to heal.
  • Rehabilitation to restore motion and strength to stabilize
  • Surgery if more severe fracture

What Type of Surgery is usually involved with Growth Plate Fracture?

The most common type of surgery for growth plate fracture is an open reduction. The surgery involves placing metal pins to hold bones in place without disturbing the growth plate.

How can Physical Therapy help with an Injury to the Growth Plate?

After growth plate injury is healed it is extremely important to restore normal and strength. Physical therapists are the specialist that are best trained to accomplish this type of rehabilitation. Additionally, physical therapists also can help prevent growth plate injuries by instructing with specific strength and flexibility exercise. These exercises can take the load off of the growth plate. Also, biomechanical education such as throwing mechanics and training activity to reduce stress load to growth plate.

7 Ways to Protect your Child from Growth Plate Injuries

  1. Sport activity: Do not play same sport year-round as same type of stress may cause microtrauma
  2. Protective equipment such as wrist brace if skating
  3. Avoid risky play such as trampoline jumping
  4. Correct warm-up and stretching before activity
  5. Proper level of fitness and strength for specific sport
  6. Proper technique for sport or activity
  7. Sudden change in type or intensity of training

Growth plate fractures is a very serious injury that can result with lasting problems that can be lifelong.Lastly, prevention and proper treatment are crucial to ensure these are not the case.

Written By: Jared Ernest MPT

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