Fractures in Children

Description

Complete or incomplete bone breaks in growing athletes are often caused by a fall or by contact injuries. Fractures may involve any part of the bone, however, the growth plate (physis) is the weakest link in the growing athlete, and fractures often involve the physis. Children’s bones are more flexible than adults, and thus they are able to absorb more force before breaking. The lining around the bone, called periosteum, is also thicker and has a greater capability for growth and remodeling than in adults.

The following are the different types of growth plate injuries:

• Separation at the physis: This injury occurs from a bending force. Instead of a ligament sprain, the physis is injured, and the bone on either side of the growth plate separates from the other. There is little risk of growth disturbance with this injury.

• Physis fracture with fracture of the bone away from the joint: This break of the bone above the growth plate, away from the joint, involves all or part of the physis. A small risk of growth injury goes with this fracture.

• Physis fracture with fracture of the bone involving the joint: A break of the bone involving the joint and growth plate, this fracture carries with it the risk of joint injury, delayed arthritis, and a slightly increased risk of growth disturbance.

• Physis fracture with fracture of the bone on both sides of the physis: A break of the bone on both sides of the growth plate, going through the growth plate and involving the joint, this fracture has the risk of joint injury, delayed arthritis, and increased risk of growth disturbance.

• Crush injury of the physis: This is a compression fracture that crushes all or part of the growth plate without breaking the bone. This injury has the highest risk of growth disturbance.

Frequent signs and symptoms

• Pain, tenderness, bleeding, bruising, and swelling at the fracture site

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