Diagnosis of Growth Plate Injuries

Doctors diagnose growth plate injuries by:

• Asking about the pain and injury, including when the pain started and how the injury happened.
• Examining your child, which may include checking the injured area for tenderness, swelling, and deformity.
• Ordering x-rays.

Because growth plates have not yet hardened into solid bone, neither the structures themselves nor injuries to them show up on x-rays. Instead, growth plates appear as gaps between the shaft of a long bone (metaphysis) and the end of the bone (epiphysis). Therefore, a growth plate injury may not be apparent on an x-ray.

Other tests doctors may use to diagnose your child’s growth plate injury include:

• Magnetic resonance imaging (MRI).
• Computed tomography (CT).
• Ultrasound.

Because these tests enable doctors to see the growth plate and areas of other soft tissue, they can help visualize the injuries and determine the type of growth plate injury.

Treatment of Growth Plate Injuries

Treatment for growth plate injuries depends on the type of injury. Treatment should start as soon as possible after injury and generally involves one or more of the following treatments.

Reduction of Fracture and Immobilization

The doctor puts the injured limb in a cast or splint after establishing normal alignment of broken bones to prevent movement of the area and allow the bone to rest. To help promote healing, your child or teen should limit any activity that puts pressure on the injured area.

If your child’s injuries cause the ends of the injured bones to be out of place (displaced), the doctor usually needs to set the bones or joints back in their correct positions. This procedure is called reduction of fractures. Depending on the type of growth plate fracture your child has, doctors can set bones by:

• Closed reduction, when the doctor aligns and sets the bone using their hands.
• Open reduction. Some growth plate injuries require surgery to align and set the bones. This procedure usually requires smooth metal pins to hold the bones in place without causing premature fusion of injured growth plates.  
  • After surgery, the doctor often uses a cast to immobilize the injured area. The cast is left in place until the injury heals.
  • The need for surgery depends on the location and extent of the injury, its effect on nearby nerves and blood vessels, and the child’s age.

If the injury is serious or treatment is delayed, the growth plate fracture can interrupt the normal growth of the bone. For example, the bone may be crooked or slightly longer or shorter than expected. To help prevent problems with bone growth, your health care provider usually recommends follow-up appointments to monitor the bone for any changes in growth and development. 

With immediate treatment, most children and teens recover without additional growth problems. How soon your child can return to their regular activities and sports depends on their recovery and the type of activity.   

Strengthening and Range-of-Motion Exercises

Your child’s doctor may recommend exercises to strengthen the muscles that support the injured area of the bone after the injury has healed. Strengthening can help improve your child’s ability to move the joint in the way that it should. A physical therapist can work with your child to design an exercise plan.

Who Treats Growth Plate Injuries?

The following health care providers may help diagnose and treat growth plate injuries:

• Orthopaedists, who treat and perform surgery for bone and joint diseases.
• Occupational therapists, who teach ways to protect joints and perform activities of daily living.
• Pediatricians, who diagnose and treat children.
• Physical therapists, who specialize in movement and strengthening muscles.
• Sports medicine physicians, who treat musculoskeletal injuries from participation in sports.