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Growth Plate Fracture(Salter-Harris Fracture)
Definition

A growth plate fracture is a crack or split in or through the growth plate of a bone. Growth plates are softer areas of the bone that are made of cartilage. They occur at both ends of the bone to allow growth through childhood. The area hardens once bones are fully mature.

There are 5 types based on what parts of the bone are fractured:

  • Type 1—fracture passes straight through the growth plate and separates the end of the bone from the shaft of the bone.
  • Type 2—fracture passes through the growth plate and the shaft of the bone.
  • Type 3—fracture passes through the growth plate and breaks off a piece of the bone.
  • Type 4—fracture passes through the shaft, the growth plate, and the end of the bone.
  • Type 5—compression (crushing) fracture of the growth plate.

Femur Fracture


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Causes

Growth plate fractures are the results of a trauma to the bone.

Risk Factors

These fractures can only occur in growing children.

Activities that are most often associated with growth plate fractures include:

  • Competitive sports such as basketball, football, or volleyball
  • Recreational activities liking skiing or skateboarding

The injury can also occur during a motor vehicle accident.

Symptoms

Symptoms can vary depending on the location and severity of the fracture. About one-third of growth plate fractures happen in the long bones of the fingers. Other common areas include the bones in the forearm and lower legs.

Symptoms but may include:

  • Pain
  • Swelling and bruising (may be mistaken for a sprain)
  • Visible deformity
  • Persistent or severe pain in the area
  • Difficulty walking or using the affected area
  • Difficulty returning to sport

Rarely, these fractures can interfere with bone growth, though the risk depends on the fracture type..

Diagnosis

The doctor will ask about your child’s symptoms and medical history. The area will be examined by the doctor.

Images of the bone may be taken with:

  • X-rays
  • MRI
  • CT scan
Treatment

The goal of treatment is to make sure the bone heals properly and can continue to grow. Treatments may include:

Immobilization

A cast or splint is often used to keep the bone in place while the fracture heals. They will also provide support and decrease pressure on the area to prevent further damage.

Surgery

Surgery may be needed to help line up and stabilize the bone. Surgery may include placing pins and screws in the bone to keep it in place.

Rarely, bone growth is impaired or stimulated by this type of fracture. Surgery may be needed to correct the growth problems.

Follow Up

It may be several months or years before growth problems develop. Your doctor will monitor your child’s growth progress until the bones reach maturity.

Prevention

To help prevent fractures, encourage your child to:

  • Wear proper padding and safety equipment when participating in sports or activities.
  • Learn the proper technique for exercise and sporting activities.
  • Take a break from sports or exercise when feeling tired.

RESOURCES:

American Academy of Family Physicians
http://familydoctor.org

American Academy of Orthopaedic Surgeons
http://www.aaos.org

CANADIAN RESOURCES:

Canadian Orthopaedic Association
http://www.coa-aco.org

Canadian Orthopaedic Foundation
http://www.canorth.org

References:

Growth Plate Fractures. American Academy of Orthopedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00040. Updated January 2010. Accessed May 22, 2013.

Fractures. Boston Children’s Hospital website. Available at: http://www.childrenshospital.org/az/Site927/mainpageS927P1.html. Accessed April 23, 2013.

Salter-Harris I Fracture of Distal Fibula. Children’s Hospital of Chicago website. Available at: https://www.luriechildrens.org/en-us/care-services/conditions-treatments/Pages/index.aspx#secS. Accessed May 22, 2013.

When your child needs a cast. Nemours’ KidsHealth.org website. Updated October 2012. Available at: http://kidshealth.org/parent/system/med_procedures/casts.html. Accessed April 23, 2013.



Last reviewed May 2013 by Michael Woods, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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