Understanding Hand Growth Plate Injuries and Their Treatment Options

Growth plates are the end areas of bones within children’s bodies. They are marked by cartilage and have not ossified yet. This makes them particularly susceptible to damage, especially when combined children’s high rate of activity and propensity for injury. Within this post, we will explore key areas related to growth plate injuries, including:

  • What are growth plates?
  • What are growth plate injuries?
  • What causes growth plate injuries?
  • What are the symptoms of growth plate injuries?
  • What are the classifications of growth plate injuries?
  • How does age affect growth plate injury treatment?
  • Is surgery necessary to treat growth plate injuries?
  • How can Motus help?

What Are Growth Plates?

Growth plates are the edges of developing bones in children. They are not solid bone. Rather, they are made of cartilage. They are found throughout the body, as well, including the thigh bone, the lower leg, the forearm, and the bones in the hands, wrists, feet, and ankles. The growth plates in the hands and wrist are particularly susceptible to injury through falling on hands and wrists. Growth plates are weaker than the surrounding bone simply because they are not yet fully ossified.

What Are Growth Plate Injuries?

Growth plate injuries are usually fractures that affect the area in question. However, growth plates can also be injured through overuse and repetitive motion, similar to such injuries in adults. Most overuse and repetitive motion-related growth plate injuries are related to playing sports. You may hear terms such as:

  • Little League elbow
  • Little League shoulder
  • Jumper’s knee
  • Sever’s disease

What Causes Growth Plate Injuries?

In most instances, growth plate injuries are caused by the same things that would cause broken bones. This can include:

  • Falling from a height
  • Falling and landing on a hand/wrist
  • Heavy object impacting the hand/wrist

What Are the Symptoms of Growth Plate Injuries?

Children can experience a wide range of symptoms after suffering a growth plate injury. These can range from mild to severe. Some children may not experience much discomfort at all, depending on the severity of the injury. Some of the most common symptoms of growth plate injuries include the following:

  • Severe pain
  • Stiffness
  • Swelling
  • Bones that appear out of place
  • Bones that appear misshapen
  • Inability to hold pressure on the hand or wrist
  • Bruising
  • Inability to move the hand or wrist

What Are the Classifications of Growth Plate Injuries?

There are actually four different growth plate injury classifications, all of which are based on the severity of the situation and the type of injury sustained by the child:

  • Type I – In this type of fracture, the bone end and growth plate are separated from the bone shaft.
  • Type II – A portion of the bone at the growth plate is broken through, and the bone shaft is also cracked. Note that this is the most common type children experience.
  • Type III – The growth plate suffers from fractures and a piece of the bone end breaks off. Most of the time, this injury is seen in older children.
  • Type IV – This type of injury involves breaking of the bone end, the bone shaft, and the growth plate.
  • Type V – This injury stems from compression force and results in crushing-related damage.

What Are the Treatment Options for Growth Plate Injuries?

Treating growth plate injuries in the hand will depend on several different factors. Your child’s age and physical development will play definitive roles. The classification of the injury will also be considered. Both surgical and nonsurgical treatments are used depending on the results of the physician’s assessment.

Nonsurgical Treatment:

  • Rest and ice
  • The use of a cast to immobilize the area
  • Use of a removable brace for immobilization
  • Use of a splint for immobilization

Note that nonsurgical treatments are usually only used if the ends of the bones still line up correctly and the fracture is not particularly severe. In more serious injuries, surgery may be required.

Surgical Treatment:

  • Reduction – Both surgical and nonsurgical reductions are performed, in which the physician realigns the fractured bone. In the surgical version, screws and wires are used to hold the bones in alignment.
  • Ridge Removal – Ridge removal usually occurs during or after the healing process and is performed to remove a ridge in the bone that may affect growth and development.
  • Reconstructive Surgery – If the injury is serious enough, the doctor may recommend reconstructive surgery.

How Does Age Affect Growth Plate Injury Treatment?

Age has a significant impact on growth plate injury treatment. In most cases, the physician will conduct what is called a bone age study. The purpose of this is to determine the age and development of the child’s bone structure in order to inform treatment options. The older the child, the more ossified their skeleton will be. In fact, female children as young as 12 years of age may have fully ossified bones and no remaining growth plates.

Female children usually mature faster than male children, with ossification finalizing between 12 and 15. Male children usually do not finish skeletal development until 16 or 17 years of age. The more filled in growth plates are, the closer treatment will be to what an adult would receive and the less concern there will be about ongoing developmental issues related to the injury.

Is Surgery Necessary to Treat Growth Plate Injuries?

No, surgery is not always necessary to treat growth plate injuries. Minor injuries to the wrist are particularly fast healing and often do so with rest and ice. However, more serious injuries will require at least reduction to realign the bones, and some may require reconstructive surgery. All types of growth plate injuries should be considered serious until assessed by a physician, though, due to the chance that bone growth patterns will be altered by the injury.

How Can Motus Help?

Motus employs occupational therapists who specialize in custom splinting. In some cases, splinting can be used to treat growth plate injuries by immobilizing the affected area. Find your occupational therapist by visiting our locations page!

Source:

https://orthoinfo.aaos.org/en/diseases–conditions/growth-plate-fractures/

https://www.webmd.com/children/growth-plate-fracture#1

https://kidshealth.org/en/parents/xray-bone-age.html

https://kidshealth.org/en/parents/growth-plates.html

https://rockymountainhospitalforchildren.com/service/hand-and-wrist-growth-plate-injuries

https://www.mayoclinic.org/diseases-conditions/growth-plate-fractures/symptoms-causes/syc-20351979

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