What Is the Prognosis for Growth in the Involved Limb of a Child With a Growth Plate Injury?
About 85 percent of growth plate fractures heal without any lasting effect.
Whether an arrest of growth occurs depends on the following factors, in
descending order of importance:
Severity of the injury--If the injury causes the blood supply to the
epiphysis to be cut off, growth can be stunted. If the growth plate is shifted,
shattered, or crushed, a bony bridge is more likely to form and the risk of
growth retardation is higher. An open injury in which the skin is broken carries
the risk of infection, which could destroy the growth plate.
Age of the
child--In a younger child, the bones have a great deal of growing to do;
therefore, growth arrest can be more serious, and closer surveillance is needed.
It is also true, however, that younger bones have a greater ability to remodel.
Which growth plate is injured--Some growth plates, such as those in the region
of the knee, are more responsible for extensive bone growth than others.
Type of
growth plate fracture--The five fracture types are described in the section, How
Are Growth Plate Fractures Diagnosed? Types IV and V are the most serious.
Treatment depends on the above factors and also bears on the prognosis.
The most frequent complication of a growth plate fracture is premature arrest
of bone growth. The affected bone grows less than it would have without the
injury, and the resulting limb could be shorter than the opposite, uninjured
limb. If only part of the growth plate is injured, growth may be lopsided and
the limb may become crooked.
Growth plate injuries at the knee are at greatest risk of complications.
Nerve and blood vessel damage occurs most frequently there. Injuries to the knee
have a much higher incidence of premature growth arrest and crooked growth.
Fractures occur when bone cannot withstand the outside forces applied to the bone. Fractures can be open or closed. Types of fractures include: greenstick, spiral, comminuted, transverse, compound, or vertebral compression. Common fractures include: stress fracture, compression fracture, rib fracture, and skull fracture. Treatment depends upon the type of fracture.
Osteomyelitis is an infection of the bone. Potential causes include injections around the bone, fractures that puncture the skin, recent surgeries, and bacterial infections that travel from other areas of the body, spreading through the blood to the bone. Symptoms include pain, fever, chills, stiffness, and nausea. Treatment involves antibiotics and pain medications. Surgery is sometimes necessary.
An injury to a ligament is called a sprain, and an injury to muscle or tendon is called a strain. Sprains and strains may be caused by repetitive movements or a single stressful incident. Symptoms include pain and swelling. Though treatment depends upon the extent and location of the injury, rest, ice, compression, and elevation are key elements of treatment.
Child abuse falls into four categories: neglect, physical abuse, sexual abuse, and emotional abuse. There are certain risk factors that predispose a child to being abused and an adult to abusing a child. Risk factors for children are age, children with learning disabilities, adopted and foster children, children with congenital abnormalities, and a past history of abuse. Parental risk factors include young or single parents, those who suffered abuse themselves, adults with substance-abuse problems or psychiatric disease, and those who didn't graduate from high school.
Juvenile arthritis (juvenile rheumatoid arthritis or JRA) annually affects one child in every thousand. There are three types of JRA: pauciarticular (less than four joints affected), polyarticular (more than four joints affected), and systemic-onset (inflamed joints with high fevers and rash). Treatment of juvenile arthritis depends upon the type the child has and should focus on treating the symptoms that manifest.
There are two categories to cold weather-related injuries. 1) no freezing of body tissue (trench foot and chilblains), and 2) freezing of body tissues (frostbite). Chilblains in general, will not need medical attention (unless there is infection). Trench foot and frostbite, however, require medical attention. Symptoms of frostbite include pain, burning, numbness, and eventually a complete loss of sensation in the affected body part. The young, elderly, and patients with certain medical conditions (diabetes, hypothyroidism, circulatory problems, and psychiatric illnesses), are more susceptible to cold weather-related injuries. People who abuse alcohol and illicit drug user are also at risk for cold weather-related injuries.
Children's health is focused on the well-being of children from conception through adolescence. There are many aspects of children's health, including growth and development, illnesses, injuries, behavior, mental illness, family health and community health.
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