Although growing pains are a common problem in children and adolescents, did you know that a fracture to the growth plate in the foot may actually be the cause? Growth plates play an important role in the development of bones, and if they become injured or disrupted, it can result in complications with the normal bone growth process. Fractures to the foot growth plate vary greatly depending on type and severity, requiring different types of treatment approaches.

At Northern Ankle Foot, we understand how important this is and provide an overview of different approaches, such as casting and surgery. Our team will be there to walk you through any concerns you might have while helping you find the right solution for each specific case.

The Importance Of the Growth Plate in Bone Development

The growth plate (epiphyseal plate) is a crucial component of bone development in children and adolescents. It is a specialized area of growing tissue located near the ends of long bones, such as those in the feet. Here are the key reasons why the growth plate is important for bone development:

Bone Lengthening

Bones develop longitudinally because of the growth plate. During childhood and adolescence, new bone tissue is created, allowing bones to lengthen. New cartilage is created by a layer of dividing cells called chondrocytes that can be found in the growth plate.

Bone Shape And Proportions

The growth plate plays a role in determining how the bones will ultimately develop. It’s important to ensure that bones develop normally and keep their structure as people age. The growth plate plays a role in the alignment and structure of the bone as a whole by directing the growth of bone tissue.

Closure And Skeletal Maturity

As children reach skeletal maturity, the growth plate gradually closes, signaling the end of bone growth. The closure of the growth plate occurs at different ages, depending on the bone and individual factors. Once the growth plate is closed, bones can no longer grow in length.

Limb Alignment And Function

The growth plate is crucial to the development and continued health of the limb. The process aids in keeping bones aligned and symmetrical as they develop. Normal weight-bearing movements like walking, running, and jumping depend on the growth plate working normally.

Causes Of Fracture In Foot Growth Plate

Some of the common causes of fractures in the foot growth plate include:

Trauma

Direct trauma or injury to the area is by far the most prevalent factor that leads to a fracture in the growth plate of the foot. Accidents, particularly those involving a quick impact on the foot, falls, and sports-related activities, can all lead to this condition. The force that is exerted on the foot can cause a fracture in the growth plate if it is severe enough.

Overuse Or Repetitive Stress

An excessive amount of strain can be placed on the growth plate of the foot if it is subjected to continuous stress or repetitive motions, such as those that are experienced during sports that include running or jumping. Over the course of time, this can cause the growth plate to develop microfractures or stress fractures.

Growth Spurts

When a person is going through a phase of fast growth, like during adolescence, their bones and growth plates are at a higher risk of being injured. During these periods of rapid growth, the growth plate may become more fragile and susceptible to fractures.

Abnormal Foot Mechanics

Structural abnormalities or biomechanical issues in the foot, such as flat feet, high arches, or improper foot alignment, can increase the risk of stress on the growth plate. These conditions can alter the distribution of forces across the foot, potentially leading to growth plate fractures.

Genetic Factors

It is true that certain individuals may have a genetic predisposition that makes their growth plates more fragile or weaker than others, and this surely leads to an increased risk of fractures. This is especially common in children going through periods of rapid growth, such as during adolescence. These individuals may have a higher chance of developing stress fractures in the growth plate.

Signs And Symptoms

Signs and symptoms of a fracture in the foot growth plate are as follows:

Pain

Pain is a common symptom of a growth plate fracture in the foot. The pain may be localized to the area around the growth plate or may radiate throughout the foot. The intensity of the pain can vary depending on the severity of the fracture.

Swelling

Swelling around the growth plate area or the entire foot is another typical symptom. The swelling may develop soon after the injury or gradually over time. Usually, there is tenderness and pain associated with it.

Difficulty In Weight Bearing

Because a growth plate fracture can prevent regular weight-bearing movements like walking, running, or jumping, the patient may find it difficult and uncomfortable to walk or place weight on the affected foot. Depending on the extent of the break, the injured person may endure discomfort and swelling. They may develop a limp or have trouble supporting their own body weight as a result.

Limited Range Of Motion

A fracture in the growth plate might cause the normal range of motion in the foot to be restricted. The individual might have trouble flexing or extending the foot, and they might also have a diminished capacity to rotate the foot.

Warmth And Redness

The wounded region may have a reddened appearance and a heated sensation to the touch. Inflammation and an increase in blood flow to the wounded region are two potential causes of this symptom.

Diagnosing A Growth Plate Fracture In The Foot

Diagnosing a growth plate fracture in the foot requires an evaluation by a professional, typically an orthopedic specialist or a pediatrician with expertise in pediatric orthopedics. The diagnostic process may involve the following:

Medical History

The medical professional will start by getting a thorough medical history, which will include details about the injury’s type, any earlier activities or incidents, and the commencement and development of symptoms. This aids in giving the diagnosis essential context.

Physical Examination

A thorough physical examination of the foot will be performed to assess for signs of a growth plate fracture. The healthcare provider will carefully examine the affected foot, looking for any visible deformities, swelling, tenderness, or abnormalities in the range of motion.

Imaging Studies

X-rays are the primary imaging technique used to evaluate suspected growth plate fractures due to their ability to reveal deformities such as fractures or displaced bones. Medical professionals may take X-rays at different angles to ensure that they obtain a comprehensive view of the injury.

In situations where a more detailed assessment is required, a CAT Scan may be ordered. MRIs allow for the visualization of cartilage, soft tissues, and any associated injuries that may not be clearly visible on X-rays alone. CAT Scans show fractures in the bone not seen on plain x-rays.

Consultation And Referral

Depending on the complexity or severity of the growth plate fracture, the healthcare provider may consult with or refer the patient to a specialized orthopedic surgeon or pediatric orthopedic specialist for further evaluation and treatment planning.

Treatment Options For A Fracture In The Foot Growth Plate

The treatment approach for a growth plate fracture in the foot depends on several factors, including the severity and location of the fracture, the age of the individual, and the potential for further growth. Here are some common treatment options:

Non-Surgical Treatment

Immobilization

In less severe cases, the foot may be immobilized using a cast, brace, or walking boot. This helps stabilize the foot, promote healing, and protect the growth plate from further injury. The duration of immobilization will depend on the specific fracture and the individual’s healing progress.

Rest And Restricted Weight Bearing

Footrest and avoiding activities that put weight on the injured foot are crucial for proper healing. Crutches or other assistive devices may be recommended to help reduce weight-bearing and protect the foot during the healing process.

Pain Management

In order to relieve pain and lessen inflammation, over-the-counter painkillers such as acetaminophen or nonsteroidal anti-inflammatory medicines (NSAIDs) may be recommended. Based on the patient’s age and medical history, the doctor will choose the right drug and dose for them.

Surgical Intervention

Repositioning The Bone

It may be necessary to perform a closed reduction operation on the fracture if it is unstable or has been displaced. This procedure includes repositioning the bone pieces so that they fit together correctly but does not involve making an incision.

Open Reduction And Internal Fixation (ORIF)

In more severe cases, an ORIF procedure may be necessary. This involves making an incision to directly access the fracture site, realigning the bone fragments, and using screws, plates, or wires to stabilize the fracture and promote healing.

Surgical Procedure For Prevention

In certain cases where the growth plate is significantly affected or there is a risk of future growth abnormalities, a surgical procedure called epiphyseal arrest may be considered. This procedure involves intentionally stopping the growth on the affected side of the growth plate to prevent further deformities or limb-length discrepancies.

Recovery And Rehabilitation After A Fracture In The Growth Plate

The recovery and rehabilitation phase after a growth plate fracture in the foot is crucial for regaining full function, restoring strength, and ensuring a successful healing process. Here are some key aspects of recovery and rehabilitation:

Immobilization And Protection

During the initial phase of recovery, the foot may be immobilized using a cast, brace, or walking boot to promote proper healing. It is important to follow the healthcare provider’s instructions regarding weight-bearing limitations and protecting the foot from further injury.

Range Of Motion Exercises

As the healing progresses and with guidance from a healthcare professional, gentle range of motion exercises may be introduced. These exercises help maintain flexibility, prevent stiffness, and promote proper joint movement in the foot.

Strengthening Exercises

Once sufficient healing has occurred, a physical therapy program will focus on strengthening the muscles surrounding the foot and ankle. These exercises may include resistance training, balance exercises, and weight-bearing exercises to improve stability, support the healing structures, and regain normal foot function.

Functional Rehabilitation

As the foot becomes stronger and more stable, functional rehabilitation exercises are introduced to simulate activities of daily living and specific functional movements. These exercises may include walking, running, jumping, and sport-specific drills, depending on the individual’s activity level and goals.

Gradual Return To Activities

The healthcare provider will guide the individual in gradually returning to regular activities, sports, and exercise. It is important to follow a gradual progression to avoid overloading the healing structures and to allow sufficient time for the bone to strengthen.

Regular Follow-Up Appointments

Throughout the recovery and rehabilitation process, regular follow-up appointments with the healthcare provider will be scheduled to monitor progress, assess healing, and make any necessary adjustments to the treatment plan.

Occurrence Of Complications In The Growth Plate Foot Fracture

While most growth plate fractures in the foot heal successfully with proper treatment and rehabilitation, there can be potential complications that may arise. These complications may include:

Growth Abnormalities

Growth plate fractures can disrupt the normal growth and development of the bone. If the fracture is not appropriately managed or if there are complications during the healing process, it can lead to growth abnormalities such as limb-length discrepancies, angular deformities, or joint incongruities.

Premature Growth Plate Closure

In some cases, a growth plate fracture may result in premature closure of the growth plate, which can impact the normal growth potential of the affected bone. This can lead to altered bone length and shape, affecting the overall function of the foot.

Malunion Or Nonunion

Improper alignment or inadequate fracture healing can result in malunion or nonunion. Malunion refers to a fracture that heals in an abnormal position, potentially leading to functional impairments. When a fracture doesn’t heal properly, it’s called a nonunion and needs additional treatment, such as surgery.

Joint Stiffness And Limited Range Of Motion

Prolonged immobilization of the foot or inadequate rehabilitation can lead to decreased flexibility and joint stiffness. This can result in a limited range of motion in the affected area, impairing walking, running, or participation in sports activities.

Prevention Of Growth Plate Fractures In The Foot

Even though it may not always be possible to prevent growth plate fractures in the foot, there are some precautions to lower the chance of harm:

Safety Precautions

Encourage the use of appropriate protective equipment, such as well-fitting footwear and ankle supports, during sports and physical activities. Follow safety guidelines and rules to minimize the risk of traumatic injuries.

Proper Conditioning And Training

Proper conditioning and training programs can help strengthen the foot muscles, enhance flexibility, and improve coordination. This can lead to better stability in the foot, reduce the risk of overuse injuries due to poor joint mechanics, and prevent stresses from impacting the growth plate.

Balanced Nutrition

For maintaining ideal bone health and strength, adequate nutrition, including a well-balanced diet rich in calcium and vitamin D, is crucial. To get individualized nutritional recommendations, speak with a medical professional or registered dietitian.

Injury Awareness And Prompt Treatment

Be aware of the signs of a growth plate fracture in the foot. If an injury is suspected, seek prompt medical attention to ensure an accurate diagnosis and appropriate treatment. Adhere to the recommended rehabilitation program and follow-up appointments. Proper rehabilitation helps restore strength, range of motion, and foot function, reducing the risk of complications.

Northern Ankle Foot Associates Is Here To Serve You!

With the right approach, recovery, and rehabilitation after a fracture in the growth plate foot can be successful with no long-term damage to the area. Suppose your child has experienced such an injury. It is always advisable to contact the primary healthcare provider or podiatrist immediately. Northern Ankle Foot is on hand to provide surgical intervention as well as comprehensive recovery and rehabilitation plans tailored to each patient’s needs. We are dedicated to providing advanced and quality treatment for any ankle- or foot-related condition. Should you need the best healthcare professional, don’t hesitate to reach out to us or call us! We know that with the right care, the road to recovery for any foot or ankle injury can be a breeze!.