How Do You Treat A Salter
Initial treatment will often focus on controlling swelling and pain. Elevation of the affected limb and icing the area may manage swelling. Pain may be treated with medications, including or local anesthetic injections, when necessary. Rest is frequently recommended to facilitate recovery.
Further treatment generally depends on the specific type of fracture and additional orthopedic evaluation. Type I and II fractures are often treated with a closed reduction, which involves setting a bone back in place without surgery. After realignment of the bone, a cast or splint is typically applied to keep the bone stable so it may heal properly. Children with these fractures usually recover with minimal effect on bone growth. On the other hand, type III and IV fractures usually require a surgical procedure, known as an open reduction, in order to set the bone back into its place, and internal fixation, in which metal is used to stabilize the bone, is often necessary. Since type V is frequently diagnosed weeks after the original injury, treatment options can vary significantly and depend on the severity of bone deformity or arrest.
What Is A Growth Plate Fracture
A growth plate fracture is a crack or break in the growth plate in the bone of a child or adolescent. A growth plate is a section of tissue, made up of cartilage, a rubbery, flexible substance, that is found at the ends of the long bones of the body .
There are two growth plates, one at each end of each long bone in the body. The growth plates determine the shape and length of the childs bone as he or she grows. Once a child has stopped growing, the growth plates will harden into solid bone.
How Common Are Growth
Researchers have found that growth-plate injuries account for 15 to 20 percent of childhood foot, ankle and leg injuries. They are most common in boys 16 years old or younger and girls 13 years or old and younger.
They are more common in boys because girls tend to reach skeletal maturity, the stage when the bones are fully formed, at an earlier age.
Growth-plate injuries have the same symptoms as severe sprains or fractures, so consult a podiatrist immediately if you notice the following symptoms:
- Inability to bear weight on the leg.
- Pain and swelling.
- A limb that looks twisted or bent.
- Unwillingness to play or run.
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Ways To Prevent Growth Plate Injuries
You may not be able to prevent growth plate injuries, but you and your child can take precautions. Dr. Ballock recommends these three:
No matter how it happens, if you suspect your child has injured a growth plate, its time to make a doctors appointment for an evaluation.
Sometimes injuries can heal on their own, Dr. Ballock says. But without treatment, kids will have more pain and a higher risk of more severe, possibly growth-stunting damage.
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At Shuman Podiatry & Sports Medicine, we treat major and minor foot and ankle problems. Get ready for summer footwear by fixing your fungal nail or ingrown nail. Correct arch problems with custom orthotics. And when it comes to growth-plate injuries, make sure your child gets the top-notch diagnosis and treatments available anywhere. for a happy, healthy future.
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Treating A Growth Plate Injury
If theres a chance your child or teen has injured a growth plate, make an appointment with your foot and ankle specialist. Proper treatment is critical and under no circumstances should your child keep running or playing while injured. Many young athletes try to minimize their injury or play through the pain, but if teens and children do not give their growing bodies time to heal, they may be setting themselves up for a more serious condition in the future.
Depending on the type of fracture and severity of the injury, your foot and ankle specialist may recommend one of these courses of treatment.
Depending on the severity of the injury, your foot and ankle specialist may recommend one of these courses of treatment.
- Immobilization of the joint. The joint will typically be immobilized in a cast or boot for 2-4 weeks to give the area time to heal. In the meantime, your child should limit their physical activities and refrain from bearing weight on the injured foot.
- Manipulation. In some cases, the doctor can manipulate the joint using his or her hands to place the bones back into their correct position. Afterward, the joint will be set in a cast for 2-4 weeks until it has healed completely.
- Surgery. For severe growth plate fractures, a surgical correction may be required. The surgical site will then be placed in a cast or boot for 4-6 weeks while the bones and soft tissues heal.
How Is A Growth Plate Fracture Treated
A growth plate fracture must be treated quickly because it may interfere with proper bone growth. Treatment varies depending on how badly the growth plate and attached bone are fractured.
This is how the various types of growth plate fractures are treated:
- Type I fracture: The doctor will usually recommend a cast for the patient to help protect the growth plate while it is healing. In most cases, after the cast is removed, the bone will have healed normally.
- Type II fracture: A cast may be required and the doctor may need to set the bone, or move it into place, to make sure it heals properly. Normal healing then takes place.
- Type III fracture: Surgery may be recommended in these cases, but healing occurs normally.
- Type IV fracture: This type of break usually requires surgery. Metal screws, pins, or plates may also be recommended to make sure all the fractured pieces are aligned for healing.
- Type Vfracture: This fracture is a serious injury and will affect the childs growth, and requires surgery.
Although everyone is different, the healing process for a growth plate fracture typically takes several weeks. The doctor may also request a year of follow-up appointments to monitor the child and make sure the bones are continuing to heal and grow normally. X-rays are usually taken at the follow-up appointments.
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Symptoms Of Growth Plate Injuries
Symptoms of a growth plate injury include:
- Persistent pain and tenderness after a sudden or overuse injury.
- Deformity, warmth, or swelling at the end of a bone.
- Changes in how your child bends their limb.
- Inability to move, put pressure on, or bear weight on a limb because of pain.
You may notice that your child self-limits the amount of time playing after a prior injury.
What Are The Symptoms Of A Growth Plate Fracture
Symptoms of a growth plate fracture include:
- Favoring the uninjured fingers, leg or arm
- Limited movement of a limb or joint
- A limb that looks different or bends awkwardly
- Swollen, bruised or tender area around the joint of the bone
Because children may not be able to tell anyone that that they are injured, adults must be alert for the symptoms or complaints from the child.
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What Causes Growth
Accidents. Falls sustained while playing sports, running or falling from a high platform is the top reason for growth-plate injuries.
Recreational activities. Children who engage in active pursuits like sledding, ice skating, using playground equipment and skateboarding can all be at risk of growth-plate injuries.
Repetitive motions. Sports and activities that require repeating the same movements, like gymnastics or diving, can also experience these injuries.
Illnesses and treatments. Certain treatments for childhood cancer or arthritis can lead to growth-plate weakness.
Extreme cold. Children who suffer from frostbite can suffer permanent growth-plate injuries and related problems including early-onset arthritis.
What You Can Do
To prepare for your conversation with the doctor, you may want to write a quick list that includes:
- Your child’s symptoms
- How the injury occurred
- Your child’s key medical information, including any other medical problems and the names of all medications and vitamins he or she takes
- The sports or recreational activities in which your child regularly participates
- Questions you want to ask the doctor
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What Causes A Growth Plate Fracture
Like fractures in other bones, growth plate fractures most often occur after a traumatic blow to the area. Sports such as football, soccer, gymnastics or dancing are typical activities during which growth plate fractures occur. Recreational activities such as skateboarding, biking, trampolining, skiing or running can also put children at risk of a growth plate fracture.
How Is A Growth Plate Injury Diagnosed
The doctor will take a medical history and examine your child, checking for warmth or swelling near the joint, and by pressing on the injured area to check for tenderness or pain. The doctor will want to know about any changes in your childs ability to bend or move a limb and may ask about such symptoms as persistent pain.
Because growth plates are not solid bone, both the growth plates and potential fractures will not always show up on X-rays. They do, however, show up as gaps between the shaft and the end of the bone. As a result, the doctor may order an X-ray of the injured limb and the opposite limb, and look for differences between the two, Dr. Socci says.
Your doctor may also order other imaging tests, including a magnetic resonance imaging or a computed tomography scan, but he or she may simply make a diagnosis based on the tenderness of the growth plate area.
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Causes & Risk Factors
Most growth plate injuries are caused by a sudden accident, such as falling or being hit hard. Many occur during competitive sports, such as football, or recreational activities, such as skateboarding. Some children get injuries from overuse incliding gymnasts, long-distance runners and baseball pitchers.
Symptoms & Types
Growth plate fractures are classified depending on the degree of damage to the growth plate itself. The American Academy of Orthopaedic Surgeons explains: Several classification systems of growth plate fractures have been developed. Perhaps the most widely used is the Salter-Harris system and is described here:
- Type I Fractures: These fractures break through the bone at the growth plate, separating the bone end from the bone shaft and completely disrupting the growth plate.
- Type II Fractures: These fractures break through part of the bone at the growth plate and crack through the bone shaft as well.
- Type III Fractures: These fractures cross through a portion of the growth plate and break off a piece of the bone end.
- Type IV Fractures: These fractures break through the bone shaft, the growth plate, and the end of the bone.
- Type V Fractures: These fractures occur due to a crushing injury to the growth plate from a compression force. They are rare fractures.
Any child who experiences an injury that results in visible deformity, persistent or severe pain, or an inability to move or put pressure on a limb should be examined by a doctor.2
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How Is A Growth Plate Injury Treated
Treatment will depend on the severity of the injury and the amount of damage it has caused to the growth plate however, in most cases you can expect a full recovery.
Your childs doctor may use a combination of the following approaches:
- A cast or splint to immobilize the injured area and allow it to heal
- Physical therapy or exercise after a fracture has healed
- Follow-up imaging
- Manipulation to move bones or joints that are out of place back into their correct position.
If the fracture becomes unstable or bone fragments become problematic, surgery may be an option. Surgery may also be used to place bones and joints that are healing improperly back into place.
Growth Plate Fractures: What You Need To Know
- Growth plates are areas at the end of certain bones that allow the bones to grow. A child continues to grow while the plates are open.
- A growth plate may fracture due to a fall or another cause.
- A physical exam and X-rays are most often used to diagnose a growth plate fracture.
- Fractures of the growth plate can interrupt normal growth if not treated properly.
- Casting and splinting are common ways to treat growth plate fractures, but surgery may also be required in certain cases.
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Common Types Of Growth Plate Fractures
Type I: Type 1 often occur in younger children. The injury goes across the growth plate and surrounding bones are not affected. They often occur in younger children and are likely to appear normal on an x-ray. Type 1 fractures are treated with a cast and healing is often fast and without complications.
Type II: This type of fracture goes across the growth plate and up the shaft of the bone. Type two is a common type of growth plate fracture and often affects older children. The broken bone often needs to be repositioned and recovery is without complications.
Type III: The fracture goes across the growth plate through the end of the bone and into the adjacent joint. These injuries usually affect older children and may involve cartilage damage. Proper positioning of the broken bone is extremely important following this type of fracture.
Type IV: The fractures go across the growth plate and through the joint cartilage. Type four fractures may involve joint cartilage and impair growth. Proper positioning is also extremely important and surgery can be required to hold the bones in the proper position.
Type V: In this type of fracture the growth plate is crushed. Because bone alignment and length can be affected, Type 5 growth plate fractures are the most concerning. Unless the growth plate is aligned perfectly and maintained during recovery, the prognosis for growth is poor.
How Growth Plates Get Damaged
Growth plate injuries happen in a similar fashion to broken bones. They can be caused by:
- Trauma such as a fall or collision: About 30% of growth plate injuries are from playing contact sports, such as football, soccer and basketball, Dr. Ballock says. Another 20% are due to recreational activities, such as skateboarding and skiing. The remaining 50% are from general accidents.
- Overuse: Little League shoulder is one example. Chronic stress on the shoulder from too much ball-throwing causes microdamage to the growth plate. Pain and swelling result. Similar damage can occur in gymnasts wrists as well as the body of any young athlete involved in repetitive training.
When a limb becomes stressed in some way, it breaks wherever its weakest, Dr. Ballock says. Cartilage is weaker than bone, so in children, injuries can be more common in the growth plate.
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Symptoms Of A Growth Plate Injury
Keep a close eye on your childs growing body and play habits. They may offer clues to a cause for concern. Your child or teen may have a growth plate injury if they:
- Have sustained an acute injury to one of their limbs
- Complain of severe pain as a result of an injury
- Can no longer play or have a worsening ability to play recreational activities after sustaining an injury
- Have a visible deformity at the injured area
- Complain of persistent pain and soreness at a joint or in the heel, regardless of injury, especially if they are very physically active
Injuries to the growth plate can be difficult to catch. In adults, an x-ray can easily detect a fracture, but in children, a growth plate fracture takes a specially trained eye.
What Is A Salter
A Salter-Harris fracture refers to a injury, or fracture, through the growth plate of a . Examples of a long bone are the in the arm and the in the leg. Present in children, the growth plate, also called the physeal or epiphyseal plate, is an area of that actively develops into new bone, increasing the bones length until the child stops growing around the ages of 14 to 18. If a Salter-Harris fracture is not diagnosed and treated quickly, it can lead to permanent arrest, during which the bone stops growing entirely. Salter-Harris fractures are the most common types of fractures in children, especially in those assigned male at birth, and are more likely to cause bone deformity or growth arrest at younger ages.
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How Is A Growth Plate Fracture Diagnosed
If there is concern that a child may have a growth plate fracture, it is important that the child be seen by a doctor as soon as possible. The doctor will examine the patient and ask the parent or caregiver about the childs medical history. As part of the examination, the doctor will gently touch the injured area and may carefully move the limb to check its range of motion.
The doctor may order X-rays of both the injured limb and the healthy one to look for any differences. The doctor may also order other imaging tests, such as a computerized tomography scan, magnetic resonance imaging or ultrasound.
Growth plate fractures are usually categorized according to the Salter-Harris classification:
Diagnosing Your Child’s Growth Plate Injury
Your foot and ankle specialist can check for a growth plate injury and bone fractures by conducting an X-ray. Although there may not appear to be a fracture, a growth plate injury might be diagnosed by comparing the differences between an X-ray image of the injured limb and an image of the opposite limb. An MRI , CT scan, or ultrasound can also aid in the diagnosis.
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