“Most pediatric orthopedists will say there is no such thing as a severe sprain in a child. A child doesn’t have a severe wrist or ankle sprain, they in fact have a crack or break in that growth plate.
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– Dr. Lonnie King, Children’s Healthcare of Atlanta

Accidents, especially bruises, sprains and broken bones, are a part of childhood. But doctors say that since children are growing, some limb injuries could have unexpected consequences – and should be watched closely.

Eight-year-old Campbell was trying out some tricks on his bicycle, when he fell on his outstretched arm and injured his wrist.

His wrist is x-rayed, but the results are inconclusive. Campbell’s injury took place on a growth plate – the cartilage-like material that children have on the ends of a growing bone.

“And it’s softer than bone,” says Dr. Lonnie King of Children’s Healthcare of Atlanta. “It’s weaker than the ligaments, the tendons, the ligaments that hold the joints together and the bones together. If something is going to give, it’s usually that growth plate. Most pediatric orthopedists will say there is no such thing as a severe sprain in a child. A child doesn’t have a severe wrist or ankle sprain, they in fact have a crack or break in that growth plate.”

Dr. King shows Campbell and his mother an x-ray of the boy’s wrist.

”If he had a crack in there, we’d never see it,” he says. “And that’s where he’s sore, kind of across through this area. And we have to assume that there’s a little crack there.”

To play it safe, the doctor has Campbell’s wrist placed in a cast. About 15 percent of all childhood fractures take place in growth plates. If left untreated, a serious growth plate injury can interfere with a limb’s development.

And that, says Dr. King, is something parents need to be aware of, whenever your child hurts an arm or leg:

”If a child injures their ankle or wrist, or complains of pain in their extremities after an injury for more than a day, even without swelling; if they won’t use it, if they won’t push up, walk, bear weight, they need to get evaluated. Because even without swelling, they can have a fracture. “

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• Some symptoms of a growth plate injury are severe or persistent pain, an inability to move or put pressure on a limb – and an injury that brings about a visible deformity. With any of these symptoms, see a doctor. (American Academy of Orthopaedic Surgeons)




• Treatment of a growth plate injury depends on the severity of the fracture. It usually involves immobilization of the affected limb with a cast or splint. If called for, the doctor may also have to put the affected bones or joints back in their correct positions – using manipulation or surgery. (Medical College of Wisconsin)
• Many growth plate injuries are a result of competitive sports – and the repetitive use of a joint or limb. Parents and coaches should be aware of the possibility of a growth plate injury when a young athlete is in significant pain. They should also not encourage the child to ignore and “play through” the pain. (Yale-New Haven Children’s Hospital)
• After a growth plate injury is healed, the child may be required to take part in strengthening and range-of-motion exercises. Long-term, follow-up exams may also take place, as your doctor monitors your child’s recuperation. (Medical College of Wisconsin)

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• National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health
• American Academy of Orthopaedic Surgeons

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