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Growth Plate (Physeal) Fractures

Growth plate injuries are an interesting and challenging group of injuries based on the unique characteristics of skeletally immature bone in the developing pediatric patient. Generally they are seen after twisting or compressive forces are applied to a bone. They can occur at any age and care must be taken to accurately diagnose and treat these injuries to prevent long term complications.

Histologically, woven bone predominates in the skeletally immature patient. Mechanically, woven bone responds differently to external stress than compact or lamellar bone found in the mature skeleton. Pediatric bone has increased capacity for plastic deformation and decreased tendency for comminution when compared to adult bone.

When growth plate injury is suspected based on the history and physical exam, x-rays or CT scans are often used to confirm or stage the diagnosis. There are multiple forms of growth plate disruptions ranging from a simple compacting injury to complete dislocation.

When evaluation of the patient and fracture injury has been assessed, closed reduction is typically attempted with consent from the patient and family to proceed to open reduction if closed reduction is not possible. Sometimes, it is even necessary to insert screws or pins to stabilize the fracture. In the post-reduction setting, immobilization and non-weight bearing protocols are often implemented. Generally pediatric patients will heal these injuries within 2 months and go forward through life without residual complications.

If you think you have suffered a growth plate injury, please make an appointment with Mid-South Foot and Ankle Specialist to find the best solution for your foot. Call us at 901-309-7700 to make an appointment today.