Injuries to the growth plate in children may cause damage to the structures at the end of the bone that will allow the child to grow to full adult size. These injuries may be misdiagnosed as a simple sprain of the foot or ankle. However, a more complex injury may be present.

Growth plates, which start to close between the ages of thirteen and eighteen can be damaged in incidents such as simple falls, sports injuries, automobile accidents or other major or minor trauma. If not recognized and treated early, a child’s growth plate injury can lead to shortening of the bone (growth ceases) as the growth plate may close prematurely. Angular deformities of the bone (a curve) may also develop. The severity of these deformities depends on the age at the time of injury, extent of the injury and the part of the growth plate that has been damaged. Certain portions of the growth plate may be injured affecting its growth while other parts grow more normally thus causing a bowing of the bone.

Symptoms of a growth plate injury may mimic a sprain. These injuries occur more frequently than realized. There will always be pinpoint tenderness on the bone and a degree of swelling that is proportional to the degree of injury to the bone. The child will often limp and try to avoid the body part. Normal treatment for a sprain may involve simple observation and application of an ace bandage. This treatment for a growth plate injury that is severe may be devastating.

Diagnostic technique for a growth plate injury involves applying manual pressure to the growth plate. If the patient feels pain, the growth plate is broken even though the x-rays may reveal a healthy bone structure. When in doubt, a CT scan may be necessary.

Treatment options (early diagnosis is crucial):

1. Immobilization in a below-the-knee cast with or without crutches may be necessary if the growth plate is well aligned. These injuries will heal on their own within four to six weeks. The younger the child, the faster it heals.

2. If the injury has caused misalignment of the growth plate it can sometimes be carefully manipulated back into place and then protected with a cast. The cast would be necessary for a minimum of four to six weeks. Non-weight bearing would be mandatory.

3. If the misalignment is more severe, surgery would be necessary to restore the growth plate to its proper position. This may help avoid later problems including malalignment or premature growth plate closure that may cause the extremity to be shortened and crooked.