Physeal growth plate injuries, also known as growth plate fractures, occur in the bones of children and adolescents who are still growing. Growth plates are areas of cartilage at the end of long bones, such as the femur, tibia, and humerus that are responsible for bone growth and development. These growth plates are weaker than the bone itself and are therefore more susceptible to injury.


Children are at risk for an additional type of musculoskeletal injury: growth-plate injuries, even though adults can also injure their bones.

Until your child reaches skeletal maturity, each long bone in the body has at least two growth (epiphyseal plates) — one at each end. The growth plate is replaced by solid bone, only when growing is finished which is sometime during adolescence.

The growth plate is the weakest part of your child’s growing skeleton. It is weaker than nearby ligaments and tendons that connect bones to other bones and muscles. Because of this weakness, injuries frequently happen in the growth plate of children and adolescents.

A child is more likely to have a bone fracture for a similar injury that would cause a sprain in an adult. Reports reveal that as many as one-third of all childhood fractures are growth-plate injuries.

Physeal growth plate injuries can be caused by a variety of factors, including trauma, overuse, or repetitive stress. They are most commonly seen in contact sports or activities that involve running, jumping, or twisting.

Growth plate fractures most often occur in these bones:

  • Thighbone (femur)
  • Lower bones of the leg (tibia and fibula)
  • Outer bone of the forearm (radius), at the wrist
  • Ankle, foot or hip bone
  • Long bones of the fingers (phalanges)

The severity of a growth plate injury can vary from a minor fracture to a complete separation of the growth plate from the bone. The injury can also affect the growth and development of the bone, leading to deformities or shortening of the affected limb.


Some examples of growth plate injuries in children result from:

  • A fall, usually while running or playing
  • Competitive sports, such as football, basketball, netball, rugby, athletics and gymnastics
  • Recreational activities, such as biking, skateboarding , surfing, trampolining, skiing

The treatment of physeal growth plate injuries depends on the severity of the injury and the age of the child. Treatment options may include immobilisation, rest, and physical therapy. In some cases, surgery may be necessary to realign the bone and promote proper healing. An orthopaedic surgeon may need to return the bones or joints to the correct positions. This could be done by hand manipulation or through surgery. After your child’s bone position is corrected, the bone will be placed in a cast to allow it time to heal without movement.

It is important to seek medical attention if a child experiences pain or swelling after a fall or other injury. A prompt and accurate diagnosis of a growth plate injury can help prevent long-term complications and ensure proper healing.

Follow-up care

After any growth-plate injury, your child should receive follow-up care from her paediatrician or orthopaedic specialist. They can ensure your child’s injury is healing properly and spot any issues that need further testing or treatment.

This article ” Physeal Injuries (growth-plate) in Children ”  does not provide medical advice and is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Please consult a doctor for all medical advice.

Meet Dr Peter Smith, a leading Orthopaedic Surgeon operating from the Mediclinic Milnerton in Cape Town, Western Cape. His practice is situated in the heart of this seaside town.  Dr Peter Smith not only offers patients the full spectrum of professional orthopaedic treatments, but specialises in total knee replacement, total hip replacement, sports injuries and the latest arthroscopic surgery techniques and computer guided surgery. He gained extensive experience in the latest arthroplasty techniques during his stay of 6 years in Australia where he performed more than a hundred primary and revision hip and knee replacements cases in a year.



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