Growth plate (physeal) injuries

Growth plates (called physes) are cartilage areas found in long bones of children up to the age of 18. These plates are the site of growth near the end of the bones. Most long bones have two growth plates-one at each end. These areas produce new bone tissue and determine the final length and shape of bones in adulthood. When young people stop growing, thees plates close and are replaced by solid bone.

As it is made of cartilage, the growth plate is the weakest part of the growing skeleton. Thus, it is liable to be injured or fractured. Usually, growth plate injuries happen due to falling or twisting and they occur twice as often in boys as in girls, because girls stop growing earlier than boys.

These injuries are usually diagnosed by x-ray and in some cases MRI is done confirm the diagnosis.


X-ray showing growth plate injury



First aid for growth plate injuries involves resting, immobiliazation and avoiding weight bearing on the affected limb. Usually this can be done by placing the limb in a cast, splint, or brace to prevent movement. Many growth plate injuries are minor, and this may be the only treatment required.

Sometimes, if bones are displaced, they have to be manipulated back into place (reduction). This is done in the emergency room or operating room under anesthesia. Then, the child may wear a splint or a brace to ensure that the bones do not move out of place.

In older children, surgery may be needed to realign the bones. Plates, screws, or wires might be used to secure the fracture so that the bone heals in its proper position. Also bone lengthening surgeries may be required to equalize the length of both lower limbs.



Most kids who are treated for growth plate injuries do not have any long-term complications. However, follow-up care is important to make sure bones are healing and continuing to grow normally. Rarely, a bony bridge may form across the fracture line, limiting the growth of the bone or causing the bone to grow in a curved position.

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