Physeal Injuries (Growth Plate Injuries)

Description

The growth plate, or physis, is a cartilage structure near the end of a bone. Bones grow in length from the cartilage production of the physis, which is followed by calcification of the cartilage. Most growth plates close, meaning they fuse or disappear; this occurs in girls by 14 to 16 years of age and in boys by 16 to 18 years, although some growth plates close as late as age 25

The growth plate is the weak link in the growing athlete; thus it is more likely to be injured than bone, muscle, or ligaments. Because of the increased blood supply at the physis, it is also more susceptible to infection. Fractures that involve the growth plate may include a piece of bone, whereas acute ligament-type injuries and muscle–tendon type injuries from overuse are associated with the growth plate becoming inflamed or separating from the underlying bone and being pulled off (avulsion fracture) with or without bone

Common signs and symptoms

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

• Weakness and inability to bear weight on the injured extremity

• Weakness or inability to use the injured extremity

• Paleness and deformity (sometimes)

• Loss of pulse, numbness, tingling, or paralysis below the fracture site, usually an extremity (any of these should be regarded as emergencies)

Causes

• Injury or sudden strain, producing a force greater than the growth plate can bear

• Repetitive stress and strain or overuse of muscles and tendons

• A sudden increase in the amount or intensity of activity

• Muscle imbalance or weakness

Factors that increase risk

• Contact sports

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