Distal Femoral Growth Plate Injury

Symptoms of a Distal Femoral Growth Plate Fracture

• Pain in and above the knee after a direct impact to the knee or force on the thigh.
• Difficulty bending or straightening the knee.
• Pain when trying to move the knee.
• Tenderness around the lower thigh bone, just above the knee.
• Rapid swelling.
• The knee may appear deformed.
• There may be a difference in leg length which was not there before.

Causes

Growth plates are located at the ends of long bones such as the Femur. This is the area from which growth occurs and is the last area of the bone to fully harden (from cartilage to bone). For this reason, injuries to the growth plates occur in children and adolescents whilst the bone is still relatively soft. At a young age a fracture such as this is more likely to occur that soft tissue damage (such as ligament injuries) as the ligaments are stronger than the bone. In adults, the soft tissue is more likely to tear before a fracture occurs.

Growth plate fractures occur from either a direct impact to the knee joint, or from a shearing force to the thigh bone. Either way it is a direct trauma and an injury which causes immediate pain and swelling.

Treatment

• Seek medical attention immediately.
• Immobilise the knee to prevent further damage until a medical professional can assess the injury.
• An X-ray will be taken to confirm the diagnosis and the extent of the fracture. However depending on the age of the patient, an MRI or CT scan will also be needed as cartilage can not be seen clearly on X-rays.

• Treatment depends on the extent of the fracture and any displacement of the bones.
• Minor fractures may simply require casting to immobilise the knee 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.