What to know about growth plate fractures in children

Growth plates are softer areas near the ends of children's bones where lengthwise growth occurs. A fall, collision, twist, or direct blow can injure one near the wrist, ankle, knee, elbow, or another joint. Swelling, tenderness, bruising, limited movement, or refusing to use the limb may occur. An initial X-ray may not show every growth plate injury, so the examination and the injury pattern matter as well as the image.

Have the child assessed promptly after an injury near a joint, especially when pain or swelling persists. Keep the limb supported, avoid running or sports, and do not try to straighten an abnormal-looking arm or leg. Use only pain medicine and dosing advice appropriate for the child from a healthcare professional. Follow instructions about a splint, cast, repeat imaging, and follow-up; activity should return gradually after healing and movement have been checked.

Go to urgent care for an obvious deformity, an open wound near the injury, severe or escalating pain, or inability to move or bear weight. Emergency assessment is needed if fingers or toes become numb, blue, pale, cold, or difficult to move, or if swelling is rapidly increasing. A child who becomes unusually sleepy, confused, or repeatedly vomits after a significant fall also needs urgent evaluation.

Ask whether the injury involves the growth plate, whether more imaging or follow-up is needed, how long school and sports restrictions last, and which changes in limb length, angle, or movement should be reported.