Growth Plate Fractures and Injuries (cont.)
What Causes Growth Plate Injuries?
While growth plate injuries are caused by an acute event, such as a fall or a
blow to a limb, chronic injuries can also result from overuse. For example, a
gymnast who practices for hours on the uneven bars, a long-distance runner, or a
baseball pitcher perfecting his curve ball can all have growth plate injuries.
In one large study of growth plate injuries in children, the majority
resulted from a fall, usually while
running or playing on furniture or
playground equipment. Competitive sports, such as football, basketball,
softball, track and field, and gymnastics, accounted for one-third of all
injuries. Recreational activities, such as biking, sledding, skiing, and
skateboarding, accounted for one-fifth of all growth plate fractures, while car,
motorcycle, and all-terrain-vehicle accidents accounted for only a small
percentage of fractures involving the growth plate.
Whether an injury is acute or due to overuse, a child who has pain that
persists or affects athletic performance or the ability to move or put pressure
on a limb should be examined by a doctor. A child should never be allowed or
expected to "work through the pain."
Children who participate in athletic activity often experience some
discomfort as they practice new movements. Some aches and pains can be expected,
but a child's complaints always deserve careful attention. Some injuries, if
left untreated, can cause permanent damage and interfere with proper growth of
the involved limb.
Although many growth plate injuries are caused by accidents that occur during
play or athletic activity, growth plates are also susceptible to other
disorders, such as bone infection, that can alter their normal growth and
development.
Additional Reasons for Growth Plate Injuries
- Child abuse can be a cause of skeletal injuries, especially in very
young children, who still have years of bone growth remaining. One study
reported that half of all fractures due to child abuse were found in
children younger than age 1, whereas only 2 percent of accidental fractures
occurred in this age group.
- Injury from extreme cold (for example, frostbite) can also damage the
growth plate in children and result in short, stubby fingers or premature
degenerative arthritis.
- Radiation, which is used to treat certain cancers in children, can
damage the growth plate. Moreover, a recent study has suggested that
chemotherapy given for childhood
cancers may also negatively affect bone
growth. The same is true of the prolonged use of steroids for
rheumatoid
arthritis.
- Children with certain neurological disorders that result in sensory
deficit or muscular imbalance are prone to growth plate fractures,
especially at the ankle and knee. Similar types of injury are seen in
children who are born with insensitivity to pain.
- The growth plates are the site of many inherited disorders that affect
the musculoskeletal system. Scientists are just beginning to understand the
genes and gene mutations involved in skeletal formation, growth, and
development. This new information is raising hopes for improving treatment
of children who are born with poorly formed or improperly functioning growth
plates.
Signs That Require a Visit to the Doctor
- Inability to continue play because of pain following an acute or sudden
injury
- Decreased ability to play over the long term because of persistent pain
following a previous injury
- Visible deformity of the child's arms or legs
- Severe pain from acute injuries that prevent the use of an arm or leg.
Adapted from Play It Safe, a Guide to Safety for Young Athletes with
permission of the American Academy of Orthopaedic Surgeons.
Next: How Are Growth Plate Fractures Diagnosed? »
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