Growth Plate Quiz

The growth plate is weaker than the nearby ligaments and tendons that connect bones to other bones and muscles. In a growing child, a serious injury to a joint is more likely to damage a growth plate than the ligaments that stabilize the joint.

Growth plate fractures make up 15 percent to 30 percent of all childhood fractures. They occur twice as often in boys as in girls, with the greatest incidence among 14-year-old boys and 11- to 12-year-old girls.

Growth plate fractures occur most often in the long bones of the fingers (phalanges), followed by the outer bone of the forearm (radius) at the wrist. These injuries also occur frequently in the lower bones of the leg: the tibia and fibula. They can also occur in the upper leg bone (femur) or in the ankle, foot or hipbone.

For example, a gymnast who practices for hours on the uneven bars, a long-distance runner or a baseball pitcher perfecting his curve ball can all have growth plate injuries.

Competitive sports, such as football, basketball, softball, track and field, and gymnastics, account for one-third of all injuries. Recreational activities, such as biking, sledding, skiing and skateboarding, account for one-fifth of all growth plate fractures. Car, motorcycle and all-terrain-vehicle accidents account for only a small percentage of fractures.

A child should never be allowed or expected to "work through the pain." Some injuries, if left untreated, can cause permanent damage and interfere with proper physical growth.

Injury from cold or frostbite can result in short, stubby fingers or premature degenerative arthritis.

Although X-rays are used to diagnose growth plate fractures, the growth plate itself does not show up on the X-ray because it hasn't yet hardened into solid bone. Instead, the growth plate appears as a gap between the shaft of a long bone, called the metaphysis, and the end of the bone, called the epiphysis. Because injuries to the growth plate may be hard to see on an X-ray, an X-ray of the noninjured side of the body may be taken so the two sides can be compared. In some cases, other diagnostic tests, such as magnetic resonance imaging (MRI), computed tomography (CT) or ultrasound, will be used.