Growth plate injury

Growing children have growth plates around their joints, which promote growth of the upper and lower limbs. Such growth plates disappear when children pass puberty, and their growth stops. These growth plates are made of cartilage tissue, which is vulnerable to damage by external forces. Therefore, various traumas can lead to growth plate damage.

Children enjoy outside activities and sports when the weather becomes warmer. This is why growth plate injuries most frequently occur in the spring and fall. Growth plate injury commonly occurs in the wrists, elbows, shoulders, knees and ankles. Sometimes, minor trauma may only cause minimal growth plate injury. However, even precise displacement of the growth plate due to severe trauma must be corrected as it may lead to growth impairment. Growth plate injury in growing children is more serious than the growth plate injury in adolescents who are at the end stage of their growth. 

It is difficult to predict how a growth plate injury will lead to various types of growth impairment. However, a growth plate injury may not be foreseen in the early stages of injury, as deformities may occur in the later part of healing. Therefore, those who have had treatment for serious trauma of the growth plate, or children who are still growing must be observed for at least two years to check for any deformities or disabilities.

Disabilities caused by a growth plate injury may include impaired lengthening of the upper and lower limbs, joint deformities due to asymmetrical growth, joint movement disorder due to joint deformities or comorbid joint fractures. Trauma to the joints of the legs, such as the knees and the ankles, can commonly lead to disabilities even with appropriate treatment. Humans are walking animals, so even a slight deformity in the ankles or the knees, or a shortening of the lower limbs as little as 2 centimeters can lead to gait abnormalities. Therefore, trauma to these areas must be treated and observed actively and carefully. Trauma to the growth plates of the wrists and shoulders are less likely to lead to growth impairment with appropriate treatment. However, it should be noted that the injury to the growth plates in the elbows is quite common, and can often lead to deformities if not treated at the right time.

Injury to the growth plate due to playing sports in children is commonly caused by excessive sports activities surpassing their abilities. Therefore, it is important that children practice sports such as inline skating or roller-blading to make the joints flexible. Trauma from falling is commonly caused by avoiding collision with others, so it may be helpful to practice sports in a place where there are not many people and on a flat, leveled surface. Even a small force can cause injury to the growth plate in the elbows, so wrist and elbow protectors should be worn for prevention. 

By Shim Jong-sup

The author is a doctor in the Department of Orthopedic Surgery at Samsung Medical Center and a professor of Sungkyunkwan University School of Medicine. ― Ed.