Bone, Joint and Muscle Conditions

Fractures and Growth-Plate Injuries

What Are Fractures and Growth-Plate Injuries?

Fractures are cracks or breaks in bones.

When children or teens break bones, they may damage their growth plates at the same time. (Other injuries, such as sprains, can also damage growth plates.)

Types of Fractures

There are several types of fractures:

Simple fractures

Soft tissue swelling. Courtesy of 'Fundamentals of Pediatric Orthopedics,' © 2003 Lippincott Williams & Wilkins

Soft-tissue swelling. Some swelling is normal after a fracture.

Simple fractures are breaks or cracks in the bone that do not break through the skin.

Open fractures

Open fractures are breaks in which the bone sticks through the skin.

Traumatic fractures

Most fractures occur due to injury, such as falling while running, pedaling a bicycle or riding a skateboard.

These types of injures happen to healthy children with healthy bones. The bone gets more force than it is able to handle and breaks.

Trauma that causes a fracture is a common reason for growth-plate injuries.

Stress fractures

Both-bone forearm fracture. Courtesy of 'Fundamentals of Pediatric Orthopedics,' © 2003 Lippincott Williams & Wilkins

Forearm with both bones fractured (above) and healed (below).

These fractures can happen when a child repeats the same position or motion over and over for long periods of time. Repeated motions can also injure growth plates.

Pathologic fractures

This type of fracture occurs because the bone is weaker than normal. A pathologic fracture is usually due to holes in the bone (bone cysts) or certain bone conditions, such as brittle bone disorder (osteogenesis imperfecta).

Brittle bone disorder is an inherited (genetic) condition where bones break easily for little apparent reason.

Fractures and Growth-Plate Injuries in Children

Because children are flexible, their bones may bend after a break. They may straighten out as they heal. This process is called remodeling.

Because of remodeling, a young person's broken bone will heal better and with less treatment than a similar break in an adult. But some fractures that look simple to treat can cause serious problems for children or teens and affect the bone's ability to grow.

In every child and teen's bones, growth occurs at specific points called growth centers or growth plates. Often, these points are near the ends of the bone. If the growth plate is damaged by a fracture or another injury, the bone may stop growing.

If the growth plate is damaged by a fracture or another injury, the bone may stop growing. This serious problem is called a growth arrest. Growth arrest can permanently stop a bone's development and change how it functions. If only part of the growth plate is damaged and stops working, the bone may grow in an uneven way.

Fractures are very common in children and teens. About half of all boys and a quarter of all girls break a bone sometime during childhood. Stress and pathologic fractures are much less common. Young people usually develop stress fractures as the result of overuse, such as prolonged running or after an increase in activity.

Fractures and Growth-Plate Injuries at Seattle Children's

At Seattle Children's, we understand children's and teens' growing bones. We have the knowledge and experience to provide expert fracture care, including surgical treatment of the most complex cases.

We treat about 2,000 children and teens with fractures each year. In the summer, when children play the hardest, we see 10 fractures on our busiest days. Many of the patients we treat are referred to us from other doctors and hospitals throughout the Pacific Northwest.

Learn more about our Fracture Program, which handles fractures and growth-plate injuries.