The growth center or growth plate is the area where tissue develops near the end of the long bones in children and adolescents. Each long bone has at least two growth (epiphyseal plates) — one at each end. When growing is finished sometime during adolescence, the growth plate is replaced by solid bone.
The growth center is weaker than the nearby ligaments and tendons that connect bones to other bones and muscles. Since the growth plate is the weakest part of the growing skeleton, injuries frequently happen there. An injury that would cause a sprain in an adult would be more likely to damage a child's growth plate.
Usually these injuries are fractures — as much as one-third of all childhood fractures. They are twice as likely to occur in boys than in girls. Girls' bodies mature earlier than boys' bodies, so their growth plates are replaced by stronger bone at an earlier age.
Growth plate fractures most often occur in these bones:
Most growth plate injuries in children result from a fall, usually while running or playing. Competitive sports including football, basketball, baseball and softball, track and field and gymnastics also create the environment for these injuries, as do recreational activities such as biking, sledding, skiing and skateboarding and roller blading.
When a growth plate injury is suspected, orthopaedic surgeons at The Children's Hospital of Philadelphia will take an X-ray of the area. If a fracture is found, a cast or splint is the first treatment option.
In about 10 percent of cases, our orthopaedic surgeons will need to return the bones or joints to correct positions. This may be done by hand (manipulation) or through surgery. After the procedure, the bone will be set in place to give it a chance to heal without movement. Our casting experts will enclose the fractured growth plate and the joints on both sides of it. Casts need to remain in place from several weeks up to several months.