Tibial Growth Plate Fracture
A distal tibial gowth plate fracture is a break of the larger of the two shin bones, at the growth plate at the ankle end of the bone. These fractures occur in children and adolescents, before the bone in this area has fully hardened.
Long bones such as the Tibia grow from the ends, in areas known as growth plates. In children these are areas of developing cartilage, which as we age and reach our full height, harden to become bone. Growth plates are the last part of the bone to ossify (harden to bone) and so are at a higher risk of fracture.
In children, an ankle injury is more likely to cause a growth plate fracture, than to damage the ligaments and tendons which support the joint, as these are stronger than the still developing bone.
Symptoms of a Tibial Growth Plate Fracture
- Pain in the ankle after a sudden force such as a twist or fall.
- Difficulty weight bearing.
- Pain when trying move the ankle.
- Swelling usually develops rapidly.
- Serious, displaced fractures may cause deformity of the ankle.
Causes
A tibial growth plate fracture usually occurs following a fall, either whilst running, or off a bike or play equipment etc. This will result in the sudden pain described above and the difficulty weight bearing.
However, growth plate fractures can also be overuse injuries, caused by repetitive stresses, as occurs in long distance running or sports such as gymnastics. In this case, the pain will develop more gradually and the child will complain of pain during activity which eases with rest.
Treatment
- If a fracture is suspected, visit a Doctor asap.
- An X-ray will be used to try diagnose the injury, although as the growth plate is still cartilage it may not show and so an MRI may be better.
- Treatment depends on the extent of the fracture and any displacement.
- Minor fractures may simply require casting to immobilise the joint for 4-6 weeks.
- Fractures where the bones are displaced will require mobilisation either manually (using the hands to manipulate them back into place) or via surgery. A cast is then used so the bones can heal in place.
- In some severe cases, the parts of bone are pinned together during surgery.
- After the immobilisation period, exercises should be performed to regain full movement, strength and balance.
