History

Patients with acute growth plate fracture typically complain of what seems to be localized joint pain, often following a traumatic event (eg, fall or collision). Swelling near a joint with focal tenderness over the physis is usually present (see the image below). Lower-extremity injuries present as an inability to bear weight on the injured side; upper-extremity injuries present with complaints of impaired function and reduced range of motion (ROM), quite similar to ligamentous injury.

$Growth plate (physeal) fractures. Clinical appeara$ Growth plate (physeal) fractures. Clinical appearance of knee of patient with minimally displaced Salter-Harris I fracture of distal femur. Impressive swelling was noted adjacent to joint, but no evidence of intra-articular swelling was present. Patient was markedly tender to palpation about distal femoral physis.

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Most acute injuries to the growth plates are from a fall. It is essential to obtain a history of sports involvement, in that 33% of acute injuries occur during sports. Hockey, football, and baseball are the activities most often involved; biking, skiing, and snowboarding are the next most common activities causing acute growth plate injury.^[4] Little League shoulder, gymnast wrist, Little League elbow, Osgood-Schlatter disease, Sever disease, and Sinding-Larsen-Johansson disease are examples of physeal injuries commonly associated with sports that involve overuse at specific apophyses.^[3]

Physical Examination

The main differential in a pediatric patient who has pain and swelling at the distal end of a long bone with normal radiographs is a sprain. If the patient has tenderness specifically directly over the bone/growth plate, the injury is most likely a Salter-Harris (SH) type I physeal injury. If the tenderness is more over the ligaments, then the injury could be a sprain. Because the ligaments are five times stronger than the physis, most "sprains" in children are actually SH I growth plate injuries.

Ligamentous laxity tests of the joints of the injured side may elicit pain and positive findings similar to those indicative of joint injury. (An SH III or SH IV fracture of the distal femur is the classic example.) Positive joint laxity test findings must not be dismissed as only involving the related joint tissues.

Differential Diagnoses

Jones C, Wolf M, Herman M. Acute and Chronic Growth Plate Injuries. Pediatr Rev. 2017 Mar. 38 (3):129-138. [QxMD MEDLINE Link].
Chen FS, Diaz VA, Loebenberg M, Rosen JE. Shoulder and elbow injuries in the skeletally immature athlete. J Am Acad Orthop Surg. 2005 May-Jun. 13 (3):172-85. [QxMD MEDLINE Link].
Arnold A, Thigpen CA, Beattie PF, Kissenberth MJ, Shanley E. Overuse Physeal Injuries in Youth Athletes. Sports Health. 2017 Mar/Apr. 9 (2):139-147. [QxMD MEDLINE Link].
Kelln R, Diamond A. Physeal (growth plate) injuries: what to know and what to be aware of in young athletes. Sports Medicine Today, American Medical Society for Sports Medicine. Available at https://www.sportsmedtoday.com/physeal-growth-plate-injuries:-what-to-know-and-what-to-be-aware-of-in-young-athletes-va-196.htm. 2021; Accessed: December 1, 2021.
Naaktgeboren K, Dorgo S, Boyle JB. Growth Plate Injuries in Children in Sports: A Review of Sever's Disease. Strength Conditioning J. 2017 Apr. 39:59-68.
Boutis K, Plint A, Stimec J, Miller E, Babyn P, Schuh S, et al. Radiograph-Negative Lateral Ankle Injuries in Children: Occult Growth Plate Fracture or Sprain?. JAMA Pediatr. 2016 Jan. 170 (1):e154114. [QxMD MEDLINE Link].
Meyers R, Provence A. Growth plate injuries in youth athletes. American Orthopaedic Society for Sports Medicine. Available at https://www.sportsmed.org/aossmimis/STOP/Blog/Posts/Growth_Plate_Injuries_in_Youth_Athletes.aspx. August 5, 2020; Accessed: November 1, 2021.
Brown T, Moran M. Pediatric Sports-Related Injuries. Clin Pediatr (Phila). 2019 Feb. 58 (2):199-212. [QxMD MEDLINE Link].
Brown T, Moran M. Pediatric Sports-Related Injuries. Clin Pediatr (Phila). 2019 Feb. 58 (2):199-212. [QxMD MEDLINE Link].
Langenskiöld A. Role of the ossification groove of Ranvier in normal and pathologic bone growth: a review. J Pediatr Orthop. 1998 Mar-Apr. 18 (2):173-7. [QxMD MEDLINE Link].
Wall EJ, Ghattas PJ, Eismann EA, Myer GD, Carr P. Outcomes and Complications After All-Epiphyseal Anterior Cruciate Ligament Reconstruction in Skeletally Immature Patients. Orthop J Sports Med. 2017 Mar. 5 (3):2325967117693604. [QxMD MEDLINE Link].
Salter RB, Harris WR. Injuries involving the epiphyseal plate. J Bone Joint Surg Am. 1963. 45-A:587-622.
Gill LE, Klingele KE. Management of foot and ankle injuries in pediatric and adolescent athletes: a narrative review. Orthop Res Rev. 2018. 10:19-30. [QxMD MEDLINE Link].
Rohmiller MT, Gaynor TP, Pawelek J, Mubarak SJ. Salter-Harris I and II fractures of the distal tibia: does mechanism of injury relate to premature physeal closure?. J Pediatr Orthop. 2006 May-Jun. 26 (3):322-8. [QxMD MEDLINE Link].
Lee SH, Lee DH, Baek JR. Proximal humerus Salter type III physeal injury with posterior dislocation. Arch Orthop Trauma Surg. 2007 Feb. 127 (2):143-6. [QxMD MEDLINE Link].
Havranek P, Pesl T. Salter (Rang) type 6 physeal injury. Eur J Pediatr Surg. 2010 May. 20 (3):174-7. [QxMD MEDLINE Link].
Rang M, ed. The Growth Plate and Its Disorders. Baltimore: Williams & Wilkins; 1969.
Mann DC, Rajmaira S. Distribution of physeal and nonphyseal fractures in 2,650 long-bone fractures in children aged 0-16 years. J Pediatr Orthop. 1990 Nov-Dec. 10 (6):713-6. [QxMD MEDLINE Link].
Neer CS, Horowitz BS. Fractures of the proximal humeral epiphyseal plate. Clin Orthop Rel Res. 1965. 41:24-31. [QxMD MEDLINE Link].
Ho-Fung VM, Zapala MA, Lee EY. Musculoskeletal Traumatic Injuries in Children: Characteristic Imaging Findings and Mimickers. Radiol Clin North Am. 2017 Jul. 55 (4):785-802. [QxMD MEDLINE Link].
Shrader MW. Pediatric supracondylar fractures and pediatric physeal elbow fractures. Orthop Clin North Am. 2008 Apr. 39 (2):163-71, v. [QxMD MEDLINE Link].
DeFroda S, McGlone P, Levins J, O'Donnell R, Cruz AI, Kriz PK. Shoulder and Elbow Injuries in the Adolescent Throwing Athlete. R I Med J (2013). 2020 Sep 1. 103 (7):21-29. [QxMD MEDLINE Link].
Cutler L, Molloy A, Dhukuram V, Bass A. Do CT scans aid assessment of distal tibial physeal fractures?. J Bone Joint Surg Br. 2004 Mar. 86 (2):239-43. [QxMD MEDLINE Link].
Pennock AT, Ellis HB, Willimon SC, Wyatt C, Broida SE, Dennis MM, et al. Intra-articular Physeal Fractures of the Distal Femur: A Frequently Missed Diagnosis in Adolescent Athletes. Orthop J Sports Med. 2017 Oct. 5 (10):2325967117731567. [QxMD MEDLINE Link].
Boutis K, Narayanan UG, Dong FF, Mackenzie H, Yan H, Chew D, et al. Magnetic resonance imaging of clinically suspected Salter-Harris I fracture of the distal fibula. Injury. 2010 Aug. 41 (8):852-6. [QxMD MEDLINE Link].
Bright RW. Physeal injuries. Rockwood CA Jr, Wilkins KE, Beaty JH, eds. Fractures in Children. 3rd ed. Lippincott-Raven; 1991. 87-186.
Leboy P, Grasso-Knight G, D'Angelo M, Volk SW, Lian JV, Drissi H, et al. Smad-Runx interactions during chondrocyte maturation. J Bone Joint Surg Am. 2001. 83-A Suppl 1 (Pt 1):S15-22. [QxMD MEDLINE Link].
Buxton P, Edwards C, Archer CW, Francis-West P. Growth/differentiation factor-5 (GDF-5) and skeletal development. J Bone Joint Surg Am. 2001. 83-A Suppl 1 (Pt 1):S23-30. [QxMD MEDLINE Link].
Adams AJ, Mahmoud MAH, Wells L, Flynn JM, Arkader A. Physeal fractures of the distal femur: does a lower threshold for surgery lead to better outcomes?. J Pediatr Orthop B. 2020 Jan. 29 (1):40-46. [QxMD MEDLINE Link].
Arkader A, Warner WC Jr, Horn BD, Shaw RN, Wells L. Predicting the outcome of physeal fractures of the distal femur. J Pediatr Orthop. 2007 Sep. 27 (6):703-8. [QxMD MEDLINE Link].
Garrett BR, Hoffman EB, Carrara H. The effect of percutaneous pin fixation in the treatment of distal femoral physeal fractures. J Bone Joint Surg Br. 2011 May. 93 (5):689-94. [QxMD MEDLINE Link].
Thomson JD, Stricker SJ, Williams MM. Fractures of the distal femoral epiphyseal plate. J Pediatr Orthop. 1995 Jul-Aug. 15 (4):474-8. [QxMD MEDLINE Link].
Riseborough EJ, Barrett IR, Shapiro F. Growth disturbances following distal femoral physeal fracture-separations. J Bone Joint Surg Am. 1983 Sep. 65 (7):885-93. [QxMD MEDLINE Link].
Moore MS, Mackenzie WG. Fracture of the proximal tibial epiphysis. Clinical Case Presentation: Alfred I. Dupont Institute. April 4, 1996.
Kling TF Jr, Bright RW, Hensinger RN. Distal tibial physeal fractures in children that may require open reduction. J Bone Joint Surg Am. 1984 Jun. 66 (5):647-57. [QxMD MEDLINE Link].
Barmada A, Gaynor T, Mubarak SJ. Premature physeal closure following distal tibia physeal fractures: a new radiographic predictor. J Pediatr Orthop. 2003 Nov-Dec. 23 (6):733-9. [QxMD MEDLINE Link].
Russo F, Moor MA, Mubarak SJ, Pennock AT. Salter-Harris II fractures of the distal tibia: does surgical management reduce the risk of premature physeal closure?. J Pediatr Orthop. 2013 Jul-Aug. 33 (5):524-9. [QxMD MEDLINE Link].
Korsh J, Adolfsen S. Displaced Salter-Harris Type I Distal Fibula Fractures: Two Case Reports and a Review of the Literature. J Foot Ankle Surg. 2017 Jul - Aug. 56 (4):845-850. [QxMD MEDLINE Link].
Bucholz RW, Ezaki M, Ogden JA. Injury to the acetabular triradiate physeal cartilage. J Bone Joint Surg Am. 1982 Apr. 64 (4):600-9. [QxMD MEDLINE Link].
Pinckney LE, Currarino G, Kennedy LA. The stubbed great toe: a cause of occult compound fracture and infection. Radiology. 1981 Feb. 138 (2):375-7. [QxMD MEDLINE Link].
Seymour N. Juxta-epiphysial fracture of the terminal phalanx of the finger. J Bone Joint Surg Br. 1966 May. 48 (2):347-9. [QxMD MEDLINE Link].
Nietosvaara Y, Hasler C, Helenius I, Cundy P. Marked initial displacement predicts complications in physeal fractures of the distal radius: an analysis of fracture characteristics, primary treatment and complications in 109 patients. Acta Orthop. 2005 Dec. 76 (6):873-7. [QxMD MEDLINE Link].
Lee BS, Esterhai JL Jr, Das M. Fracture of the distal radial epiphysis. Characteristics and surgical treatment of premature, post-traumatic epiphyseal closure. Clin Orthop Relat Res. 1984 May. (185):90-6. [QxMD MEDLINE Link].
Rabin S, Weinstein L, Brown L. Epiphyseodesis as an alternative to distal ulna resection for post-traumatic wrist deformity in children: a review of the literature and report of two cases. Loyola Orthop J. 1994 May. 3:
Steiger CN, Ceroni D. Mechanism and predisposing factors for proximal tibial epiphysiolysis in adolescents during sports activities. Int Orthop. 2019 Jun. 43 (6):1395-1403. [QxMD MEDLINE Link].
Stracciolini A, Casciano R, Levey Friedman H, Stein CJ, Meehan WP 3rd, Micheli LJ. Pediatric sports injuries: a comparison of males versus females. Am J Sports Med. 2014 Apr. 42 (4):965-72. [QxMD MEDLINE Link].
Ramponi DR, Baker C. Sever's Disease (Calcaneal Apophysitis). Adv Emerg Nurs J. 2019 Jan/Mar. 41 (1):10-14. [QxMD MEDLINE Link].
Bärtschi N, Scheibler A, Schweizer A. Symptomatic epiphyseal sprains and stress fractures of the finger phalanges in adolescent sport climbers. Hand Surg Rehabil. 2019 Sep. 38 (4):251-256. [QxMD MEDLINE Link].
Paz T, Meyers RN, Faverio CN, Wang Y, Vosburg EM, Clewley DJ. Youth Distance Running and Lower Extremity Injury: A Systematic Review. Int J Environ Res Public Health. 2021 Jul 15. 18 (14):[QxMD MEDLINE Link].
Basener CJ, Mehlman CT, DiPasquale TG. Growth disturbance after distal femoral growth plate fractures in children: a meta-analysis. J Orthop Trauma. 2009 Oct. 23 (9):663-7. [QxMD MEDLINE Link].
Leary JT, Handling M, Talerico M, Yong L, Bowe JA. Physeal fractures of the distal tibia: predictive factors of premature physeal closure and growth arrest. J Pediatr Orthop. 2009 Jun. 29 (4):356-61. [QxMD MEDLINE Link].

Media Gallery

Growth plate (physeal) fractures. Clinical appearance of knee of patient with minimally displaced Salter-Harris I fracture of distal femur. Impressive swelling was noted adjacent to joint, but no evidence of intra-articular swelling was present. Patient was markedly tender to palpation about distal femoral physis.
Growth plate (physeal) fractures. Anteroposterior radiograph of knee of patient in previous image. Note subtle physeal widening, confirming diagnosis of Salter-Harris I fracture of distal femur.
Growth plate (physeal) fractures. Anteroposterior ankle radiograph demonstrates impressively displaced Salter-Harris II fracture of distal tibial epiphysis (along with comminuted fracture of distal fibular diaphysis).
Growth plate (physeal) fractures. Displaced Salter-Harris II fracture of distal femur. Large Thurstan Holland (metaphyseal) fragment may serve as important fixation point for either Steinmann pin or lag screw.
Growth plate (physeal) fractures. Multiple computed tomography (CT) scans depict displaced Salter-Harris III fracture of distal anterolateral tibial epiphysis (ie, Tillaux fracture).
Growth plate (physeal) fractures. Displaced Salter-Harris IV fracture of proximal tibia. Lateral portion of epiphysis (with Thurstan Holland fragment) and medial portion of epiphysis are independently displaced (ie, each is free-floating fragment).
Growth plate (physeal) fractures. Salter-Harris V fracture pattern must be strongly suspected whenever mechanism of injury includes significant compressive forces. This is initial injury radiograph of child's ankle that was subjected to significant compressive and inversion forces. It demonstrates minimally displaced fractures of tibia and fibula with apparent maintenance of distal tibial physeal architecture.
Growth plate (physeal) fractures. Follow-up radiograph of ankle of child in preceding image. This radiograph depicts growth arrest secondary to Salter-Harris V nature of the injury. Note markedly asymmetric Park-Harris growth recovery line, indicating that lateral portion of growth plate continues to function and medial portion does not.
Growth plate (physeal) fractures. Mortise radiograph demonstrating somewhat subtle physeal injury to distal tibia. Salter-Harris VI pattern may be suspected on basis of history and physical examination. In this case, radiograph indicates that it is quite likely that small portion of peripheral medial physis (as well as small amount of adjacent epiphyseal and metaphyseal bone) has been avulsed.
Growth plate (physeal) fractures. Clinical photograph of patient above with displaced Salter-Harris II fracture of distal femur. Mechanism of injury and physical examination findings are consistent with Salter-Harris VI physeal injury pattern. Some may also refer to this injury type as Kessel fracture.
Growth plate (physeal) fractures. Radiographic evidence of pediatric stubbed great toe.
Growth plate (physeal) fractures. Clinical appearance of pediatric stubbed great toe. Note subungual hematoma, representative of open fracture.
Growth plate (physeal) fractures. Oblique view of distal femur reveals Salter-Harris III fracture of distal femur.
Growth plate (physeal) fractures. Anteroposterior and lateral views of distal femur Salter-Harris III fracture where fracture is not well seen.
Growth plate (physeal) fractures. Fixation of Salter-Harris III fracture of distal femur.
Growth plate (physeal) fractures. Proximal tibia apophyseal avulsion fracture (anteroposterior, lateral, and oblique images).
Growth plate (physeal) fractures. Proximal tibial apophyseal tuberosity avulsion fracture.
Growth plate (physeal) fractures. Proximal tibia apophysis avulsion as seen on CT.
Growth plate (physeal) fractures. Fixation of proximal tibia apophysis avulsion fracture (healed).
Growth plate (physeal) fractures. Triplane fracture of distal tibia (anteroposterior and lateral images).
Growth plate (physeal) fractures. Healed triplane fracture of distal tibia after internal fixation.
Growth plate (physeal) fractures. Sagittal and axial CT images of triplane fracture of distal tibia.
Growth plate (physeal) fractures. 3D CT images of triplane fracture of distal tibia are useful for preoperative planning.
Growth plate (physeal) fractures. Tillaux fracture of distal tibia seen on anteroposterior radiograph.
Growth plate (physeal) fractures. Healed Tillaux fracture of distal tibia after internal fixation.
Growth plate (physeal) fractures. Tillaux fracture of distal tibia epiphysis that is not well seen on anteroposterior radiograph.
Growth plate (physeal) fractures. Tillaux fracture that was not well seen on plain radiographs is now relatively easy to see on axial CT image.
Growth plate (physeal) fractures. Radial head fracture in child that is difficult to see on standard anteroposterior and lateral images.
Growth plate (physeal) fractures. Radial head fracture in child that was difficult to see on anteroposterior and lateral images is now well seen on oblique view.
Growth plate (physeal) fractures. Open reduction and internal fixation of radial head fracture in child.
Growth plate (physeal) fractures. Angulated proximal humerus fracture in child (anteroposterior and Y views).
Growth plate (physeal) fractures. Healed proximal humerus with abundant callus and angulation in child.
Growth plate (physeal) fractures. Remodeling of proximal humerus fracture in child.
Growth plate (physeal) fractures. Displaced Salter-Harris II fracture of distal femur.
Growth plate (physeal) fractures. Percutaneous internal fixation of Salter-Harris II fracture of distal femur after anatomic stable closed reduction.
Growth plate (physeal) fractures. Healed Salter-Harris II fracture of distal femur in anatomic position.
Growth plate (physeal) fractures. Anatomic reduction of previously displaced Salter-Harris II fracture of distal femur.
Growth plate (physeal) fractures. Posttraumatic Madelung deformity treated with epiphyseodesis of distal ulna to allow radius growth to catch up.
Growth plate (physeal) fractures. Comparison views of two wrists show almost equal ulnar variance (with correction of previously Madelung deformity by epiphyseodesis).
Growth plate (physeal) fractures. Posttraumatic Madelung deformity with ulna outgrowing radius in skeletally immature child.
Growth plate (physeal) fractures. Application of Ilizarov external fixator frame with corticotomy for distraction osteogenesis correction of leg-length discrepancy.
Growth plate (physeal) fractures. Equal leg lengths (healing) after Ilizarov distraction osteogenesis.
Growth plate (physeal) fractures. 14-year-old girl with leg-length discrepancy.
Growth plate (physeal) fractures. Ilizarov distraction osteogenesis for leg-length discrepancy.
Growth plate (physeal) fractures. Procurvatum of proximal tibia after open reduction and internal fixation of proximal tibia apophysis injury.
Growth plate (physeal) fractures. Epiphyseodesis performed too late to correct procurvatum deformity of proximal tibia.
Growth plate (physeal) fractures. Anatomic reduction with percutaneous cross pinning of Salter-Harris II fracture distal femur.
Growth plate (physeal) fractures. Growth arrest of distal femur at skeletal maturity after Salter-Harris II fracture of distal femur.
Growth plate (physeal) fractures. Scanograms to assess leg lengths after growth plate arrest following Salter-Harris II fracture of distal femur.
Growth plate (physeal) fractures. Corrective osteotomy after growth arrest deformity following Salter-Harris II fracture of distal femur.
Growth plate (physeal) fractures. Healed Salter-Harris III fracture of distal femur with pain over retained hardware (screw head).
Growth plate (physeal) fractures. Resolution of pain after removal of hardware; healed Salter-Harris II fracture of distal femur.
Growth plate (physeal) fractures. Minimally displaced Salter-Harris III fracture of distal radius.
Growth plate (physeal) fractures. Central deformity of distal radius with growth retardation and relative lengthening of distal ulna after Salter-Harris III fracture of distal radius.
Growth plate (physeal) fractures. Partial correction of deformity (improvement of ulnar variance) after ulnar epiphyseodesis to correct growth retardation of distal radius following Salter-Harris III fracture. Earlier diagnosis and intervention might have improved results.
Growth plate (physeal) fractures. Growth retardation of distal ulna with negative ulnar variance after open reduction and internal fixation of distal radius fracture.
Growth plate (physeal) fractures. Tibia shaft fracture in child.
Growth plate (physeal) fractures. Healed tibia shaft fracture in child.
Growth plate (physeal) fractures. Comparison radiographic views (anteroposterior and lateral, both knees) showing procurvatum deformity of proximal tibia due to growth retardation remote from prior tibial shaft fracture.
Growth plate (physeal) fractures. Opening wedge osteotomy to correct procurvatum deformity of proximal tibia.
Growth plate (physeal) fractures. Healed proximal tibia osteotomy.
Growth plate (physeal) fractures. Salter-Harris I fracture of distal radius.
Growth plate (physeal) fractures. Healed and remodeled Salter-Harris I fracture of distal radius.
Growth plate (physeal) fractures. Closed reduction and percutaneous pinning of Salter-Harris II fracture of distal radius.
Growth plate (physeal) fractures. Triradiate cartilage fracture seen on anteroposterior pelvis x-ray.
Growth plate (physeal) fractures. Triradiate cartilage fracture seen on axial CT.
Growth plate (physeal) injuries. Little League shoulder. Note irregularity of proximal humeral physis with metaphyseal sclerosis.
Growth plate (physeal) injuries. Little League elbow. Note widening of medial epicondyle physis.
Growth plate (physeal) injuries. Medial epicondyle avulsion fracture in child. Note widening of medial apophysis.

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Table 1. Physeal Injury Patterns in Male and Female Athletes

Table 1. Physeal Injury Patterns in Male and Female Athletes

Mechanism and Site of Injury	Males	Females
Mechanism
Acute trauma	58.2%	37.5%
Overuse	41.8%	62.5%
Site
Lower extremity	53.7%	65.8%
Upper extremity	29.8%	15.1%
Spine	8.2%	11.3%

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Author

Steven I Rabin, MD, FAAOS Clinical Associate Professor, Department of Orthopedic Surgery and Rehabilitation, Loyola University, Chicago Stritch School of Medicine; Medical Director, Musculoskeletal Services, Dreyer Medical Clinic

Steven I Rabin, MD, FAAOS is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American College of Surgeons, American Fracture Association, American Orthopaedic Association, AO Foundation, Chicago Metropolitan Trauma Society, Illinois Association of Orthopaedic Surgeons, Limb Lengthening and Reconstruction Society, Mid-America Orthopaedic Association, Orthopaedic Trauma Association

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

George H Thompson, MD Director of Pediatric Orthopedic Surgery, Rainbow Babies and Children’s Hospital, University Hospitals Case Medical Center, and MetroHealth Medical Center; Professor of Orthopedic Surgery and Pediatrics, Case Western Reserve University School of Medicine

George H Thompson, MD is a member of the following medical societies: American Orthopaedic Association, Scoliosis Research Society, Pediatric Orthopaedic Society of North America, American Academy of Orthopaedic Surgeons

Disclosure: Received none from OrthoPediatrics for consulting; Received salary from Journal of Pediatric Orthopaedics for management position; Received none from SpineForm for consulting; Received none from SICOT for board membership.

Chief Editor

Jeffrey D Thomson, MD Professor of Orthopedic Surgery, University of Connecticut School of Medicine; Director of Orthopedic Surgery, Connecticut Children’s Medical Center; Vice President of Medical Staff, Connecticut Children's Medical Center

Jeffrey D Thomson, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, Pediatric Orthopaedic Society of North America, Scoliosis Research Society

Disclosure: Nothing to disclose.

Additional Contributors

Charles T Mehlman, DO, MPH Professor of Pediatrics and Pediatric Orthopedic Surgery, Division of Pediatric Orthopedic Surgery, Director, Musculoskeletal Outcomes Research, Cincinnati Children's Hospital Medical Center

Charles T Mehlman, DO, MPH is a member of the following medical societies: American Academy of Pediatrics, American Fracture Association, Scoliosis Research Society, Pediatric Orthopaedic Society of North America, American Medical Association, American Orthopaedic Foot and Ankle Society, American Osteopathic Association, Arthroscopy Association of North America, North American Spine Society, Ohio State Medical Association

Disclosure: Nothing to disclose.

Matthew E Koepplinger, DO Assistant Professor, Department of Orthopedic Surgery, Baylor College of Medicine; Staff Physician, Department of Orthopedic Surgery, Ben Taub General Hospital

Matthew E Koepplinger, DO is a member of the following medical societies: American Osteopathic Association, American Osteopathic Academy of Orthopedics

Disclosure: Nothing to disclose.

Mininder S Kocher, MD, MPH Associate Professor of Orthopedic Surgery, Harvard Medical School/Harvard School of Public Health; Associate Director, Division of Sports Medicine, Department of Orthopedic Surgery, Children's Hospital Boston

Mininder S Kocher, MD, MPH is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American College of Sports Medicine, Pediatric Orthopaedic Society of North America, American Association for the History of Medicine, American Orthopaedic Society for Sports Medicine, Massachusetts Medical Society

Disclosure: Received consulting fee from Smith & Nephew Endoscopy for consulting; Received consulting fee from EBI Biomet for consulting; Received consulting fee from OrthoPediatrics for consulting; Received stock from Pivot Medical for consulting; Received consulting fee from pediped for consulting; Received royalty from WB Saunders for none; Received stock from Fixes-4-Kids for consulting.

Sections Growth Plate Fractures (Physeal Fractures)
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Presentation
DDx
Workup
Treatment
Media Gallery
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References

Growth Plate Fractures (Physeal Fractures) Clinical Presentation

History

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References

Tables

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