GROWTH PLATE INJURIES

Children are not little adults. Their musculoskeletal system contains growth plates made of cartilage called physes. Though children can injure ligaments and tendons (connections between bones and between muscles to bones, respectively) and fracture bones like adults, growth plates are relative “weak links” in the pediatric musculoskeletal system prone to injury.
Five common patterns of fracture involving growth plates have been identified. The pediatric orthopedist takes into account the location of the injury, the age of the patient, and the fracture pattern to determine whether treatment requires surgery or simple casting.

Some teenagers sustain unique fracture patterns attributable to their growth plates. This is an example of a transitional ankle fracture called a Tillaux fracture. Due to the nature of this closing growth plate, a small portion of the distal tibia is avulsed, or broken off (CT Scan image on left). Because the joint space is separated, an anatomic restoration is needed (Xray images middle and right).

Tibial tubercle fracture (a type of knee fracture seen after a violent eccentric contraction of the quadriceps muscle)

F. Brett Shannon, DO • John A. Churchill, MD • Matthew R. Wagner, MD • Michael J. Young, PA-C • Ashley Courtney, PA-C • Phone: 239.432.5100