Everyone is at risk of breaking a bone. Children have an extra risk of injury: Growth plate fracture is also called growth plate injury. What is it?

Published: January 22, 2020 | Updated: April 21, 2023

Everyone of us, young and old, is at risk for taking a stumble and breaking a bone, an injury also called a fracture. Children, however, are at risk for an additional type of injury: the growth plate fracture, also called growth plate injury. What is it, and how does it happen?

What is the growth plate?

The growth plate, also called the growth center, is the tissue that helps children and teens grow at the ends of long bones. The tissue is flexible and rubbery and made of cartilage. This flexible tissue hardens when a child is finished growing, becoming solid bone around ages 15 to 17 for boys and ages 13 to 15 in girls. Until a child finishes growing, each of the long bones has two growth plates at the end of the bone, called epiphyseal plates.

How does a child break the growth plate?

Until a child finishes growing, the growth plate is the weakest part of your child’s bones. It’s weaker than the nearby ligaments and tendons that connect bones to bones and other muscles. Injuries that would cause sprains in adults are more likely to cause a bone fracture in a child. It’s this weakness that leads to injuring, or fracturing, the growth plate. About 1 in 3 childhood fractures are growth plate injuries.

Growth plate fractures can be caused by:

• Falls while running or playing
• Sports such as baseball, basketball, football, gymnastics, softball or track
• Outdoor activities, including biking, rollerblading, skateboarding, sledding and skiing

Boys are more likely to experience growth plate fractures, at almost twice the rate as girls. This is because girls mature faster than boys, and their growth plates harden sooner.

Which bones are most likely affected by growth plate fractures?

Children are more likely to have growth plate fractures in their:

• Ankle bone
• Wrist/forearm
• Around the knee, such as upper shinbone
• Thighbone
• Fingers
• Foot bones

Growth plate fracture treatment

A pediatric orthopedist can assess and diagnose a growth plate injury in your child. In most cases, an X-ray will be used to assess the injury, but often may not show specific evidence of injury. In fact, X-rays often can appear normal. This is where the expertise of a pediatric orthopedic doctor is very important. In some cases, additional imaging may be needed, including computed tomography (CT) scan, magnetic resonance imaging (MRI) and bone scan.

Treatment depends on the severity of your child’s growth plate fracture. Some treatments include:

• A pediatric orthopedist can cast or splint the bone or joint.
• A pediatric orthopedist may return the bone to the correct position by hand or set the bone through surgery.
• After corrective setting or surgery, the fractured growth plate and joints will be enclosed on both sides with a cast. The cast will need to remain in place for several weeks up to several months depending on the injury.
• Follow-up care by a pediatric orthopedist is needed to make sure the injury is healing properly.

The good news is that in most cases, a growth plate fracture is not a serious injury, and likely will not lead to any long-term issues with the bone growth.

The providers at Norton Children’s Orthopedics of Louisville, affiliated with the UofL School of Medicine, are experienced in treating injuries to growing bones such as growth plate injuries.