Distal Femoral Growth Plate Injury

A distal femoral growth plate injury is usually a fracture to the growth plate of the femur or thigh bone at the knee joint end of the bone. This occurs mostly in children and adolescents.


Symptoms of a distal femoral growth plate fracture include pain in and above the knee after a direct impact to the knee or force on the thigh. The athlete will have difficulty bending or straightening the knee and pain when trying to move the knee. Tenderness around the thigh bone may be felt along with rapid swelling. The knee may appear deformed and a difference in leg length may be seen which was not apparent before.


Growth plates are located at the ends of long bones such as the femur. It is the area from which growth occurs in the bone and is the last area of the bone to fully harden and turn from cartilage into 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 than 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.


Seek medical attention immediately. Immobilize 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 immobilization period, exercises should be performed to regain full movement, strength and balance.