Growth Plate Injuries (original) (raw)

Overview of Growth Plate Injuries

The growth plate is the area of tissue near the ends of long bones in children and teens that determines the future length and shape of the mature bone. Each long bone has at least two growth plates, one at each end, and they are longer than they are wide. For example, the femur (thigh bone), radius and ulna (forearm), and the metacarpal bones (hands and fingers) are long bones. Once your child’s growth is complete – sometime during adolescence – the growth plates close and are replaced by solid bone.

The growth plates are weak areas of your child’s growing skeleton. Because they are even weaker than the nearby ligaments and tendons that connect bones to other bones and muscles, growth plates are vulnerable to injury. Injuries to the growth plate (fractures) can result from a single traumatic event, such as a fall or automobile accident, or from chronic stress and overuse.

Children and teens with growth plate injuries often need immediate treatment to prevent problems with bone growth. However, with proper treatment, most growth plate fractures heal without any lasting effect.

Types of Growth Plate Injuries

Doctors use a classification system called the Salter-Harris to divide most growth plate injuries and fractures into five types. Understanding the anatomy of long bones can help you understand the types of growth plate injuries. Long bones have four major areas:

• Epiphysis: the end of the bone near the joint.
• Physis: the growth plate.
• Metaphysis: the area between the growth plate and the shaft.
• Diaphysis: the shaft of the long bone between growth plates above and below.

The Salter-Harris types are:

• Type I happens when the fracture passes through the physis but does not involve the area of bone around the growth plate.
• Type II happens when the fracture runs through the physis and the metaphysis. This is the most common type of growth plate fracture.
• Type III happens when fractures run through the epiphysis and growth plate. This leads to a separation of epiphysis and physis from the metaphysis.
• Type IV happens when fractures run through the physis, metaphysis, and epiphysis.
• Type V is a compression fracture through the physis that happens when the end of the bone is crushed, and the physis is compressed. This type of fracture is rare.

Sometimes, doctors include the Peterson classification when describing growth plate injuries. This system includes a type VI, which happens when a portion of the epiphysis, physis, and metaphysis are missing. This usually happens from a severe traumatic injury that includes open wounds or compound fractures.