Kids grow. Geez, that’s not much of a story, huh? It isn’t, but where kids’ bones grow, a special area called the growth plate, is maybe something many people don’t know much about. These growth plates are really important when it comes to broken bones – also known as fractures – in kids. Here’s a little serving on growth plates to help you understand why.

As I mentioned, kids grow, and their bones must grow to help make that happen. But bones – and we’re talking about the long bones here, like leg, arm, and finger bones – grow at a special place near their ends. This place is like a little slice through the bone that is filled with cartilage. (Cartilage is a “connective” tissue in the body, softer than bone, but more firm than muscle. The stiff parts of your ears and the lower part, the wiggly part, of your nose are good examples.) It’s in these cartilage zones where new bone is made that allows long bones to get longer.

So long bones don’t stretch out from the middle; they grow by getting new bone added from these special areas of cartilage near their ends. This works pretty well (obviously), but the design has some risks:

• The growth plate cartilage is pretty weak compared to bones and muscles nearby
• The blood supply to growth plate cartilage is less vigorous than that to most body tissues
• Injuries to growth plates can mess up a kid’s growth

Growth plate injuries, a type of fracture, come in different “flavors” depending on whether the injury happens through the plate, across the plate, all the way across, partially across, or if it’s crushed (compared to cracked).

Fractures, even possible fractures, should always be evaluated by a physician trained to know what to look for. (You may even need an “orthopaedic specialist”, a doc who is an expert at identifying and fixing bones.) This is especially important in children with possible fractures to growth plates as this could cause them to have unusual bone growth. Most growth plate fractures cause bones to grow less than they should or maybe make them grow crookedly. But, sometimes such a fracture can cause them to grow faster. Either way, such fractures could lead to one arm or leg growing much differently than its partner on the child’s other side, make a finger grow differently leading to problems using that hand, make one foot different from the other causing problems with walking, etc.

According to the American Academy of Orthopaedic Surgeons, somewhere around 2-3 of every 10 fractures in kids involves growth plates, so they’re pretty common. Fortunately, with good care, very few of them will have growth problems that can’t be helped.
 

Dr. Gregg
Posted – April 10, 2012