Fixation Growth Plate Fractures Treatment & Surgery
The best treatment and surgery for your child’s growth plate fracture depends on a number of factors, including their age, their current health, their past health history, the severity of their fracture and their history with various other medications and treatments. Growth plate fractures, which are a partial or complete break through the growth plate in children, are the result of a traumatic injury in most cases.
Growth Plate Fracture Diagnosis
Left untreated, a growth plate fracture can cause significant pain and also stunt proper development of a child’s body. If you have any reason to suspect that your child has broken a bone either partially or completely, it is important to see a doctor right away. In order to diagnose whether a growth plate has been fractured, the doctor will begin by asking questions about the injury, then perform a physical exam, which will consist of one or more of these tests:
- X-Ray (Radiograph) – This is usually the first test performed as it can tell the approximate location of the breakage. The growth plates are not shown on the X-ray results as they are not ossified bone. Therefore, the X-ray will usually be not only of the limb in pain, but also of the surrounding limb to ensure the fracture did not spread through the growth plate to another bone.
- Computed Tomography Scan (CT or CAT scan) – If a more extensive fracture is suspected, a CAT scan may be performed to get more detail in the area of the injury.
- Magnetic Resonance Imaging (MRI) – Sometimes, an MRI may be performed to reduce the amount of radiation a child is exposed to. This test works by placing the patient in a magnetic tube and using magnetic resonance to create images of the bone and surrounding area.
Nonsurgical Treatment for Growth Plate Fracture
If the growth plate fracture is minor, simple tactics to immobilize the bone and allow it to heal on its own may be used. This involves placing a cast on the affected area, which can remain on for as many as six weeks. After the cast is removed, the child will usually work with a physical therapist to help regain movement in the joint or area where the bone was broken. In more severe cases, when the bone is misaligned, the doctor may help realign the bone prior to casting by using pressure. This requires local or full anesthesia.
Growth Plate Fracture Surgery
In most cases, growth plate fractures require surgery to help the bone develop correctly. The goal of most growth plate fracture surgeries is to repair the breakage so the bone development is not stunted due to injury. The majority of growth plate fractures are treated using these surgeries:
- Open Reduction – This is the traditional surgical approach. It is performed by making an incision and realigning the bone by using screws, pins or rods. This is often used when soft tissue becomes damaged and therefore is trapped in between the growth plate fracture.
- Growth Plate Arrest – This procedure is usually performed when a significant period of time has passed since the fracture. Sometimes when a growth plate breaks, the injury causes the growth plate to close too soon and stunt the development of the bone. In the case of growth plate arrest, the bone directly to the side of the injured bone is also operated on to stop its growth so that it does not cause a misalignment in that area of the body.
- Bar Resection – When a growth plate fracture causes only a part of the growth plate to prematurely close, this procedure allows the doctor to go in and reopen the growth plate so development can continue as normal.
Growth Plate Fracture Research
The majority of growth plate fracture research has to do with studying how to allow the body to continue developing normally once this fragile part of the development puzzle has been damaged. This includes how to remove the area that blocks the growth plate from operating correctly after a fracture, how drugs can stop the growth plates from being affected during radiation, and how to reengineer tissue to redevelop musculoskeletal tissues and help development occur more naturally.
Currently, the National Association of Arthritis and Musculoskeletal and Skin Diseases (NAIMS) is supporting a study to use MRI results as a way to determine new ways to treat these breakages. While developments have been made, studies are ongoing as there is still much to be learned about the best way to treat growth plate fractures so the bones can continue developing normally.
Other studies being done by the American Academy of Orthopedic Surgeons are looking at the cause of growth plate fractures. Its findings have so far led to the determination that children who are obese face significantly more risk of obtaining these types of injuries because of the added weight placed on the growing bone. Overall, 74% of obese children are likely to develop growth plate fracture injuries. The study determined the likelihood of risk during a variety of activities and obese children consistently ranked higher in their risk of obtaining this injury.
As research on growth plate fractures is ongoing, it is a good idea for your conversation with your doctor to be ongoing as well.