The epiphyseal is also called as the growth plate is a hyaline cartilage plate located at the end of the long bone. It is found in children where there is presence of developing tissue at the end of the long bones. There is at least one growth plate that is present at the end of every long bone. When growth of a person is completed, the growth plates are replaced by solid bone. Any sort of injury, which can be considered as serious, to a joint often injures the growth plate, as it is the weakest area of a growing skeleton.[1] The commonest of growth plate injuries are fractures and they are more common in boys than girls.
Fracture of distal plate of femur within knee joint is classified into 5 types of fracture as shown in image. The fracture is often seen in children and young adult since the growth plate is softer than normal bone.
How To Identify Distal Femoral Growth Plate Fracture?
Symptoms of Distal Femoral Growth Plate Fracture
- A direct trauma impacting the knee/thigh produces acute pain in the knee.
- It becomes very painful to bend or straighten the knee.
- Movement of the knee is painful.
- Presence of tenderness above the knee and around the lower thigh bone.
- Instant swelling after the occurrence of fracture.
- Knee appears twisted.
- There can be cases of leg length discrepancy.
Causes of Distal Femoral Growth Plate Fracture
Growth plate is the area responsible for growth. As stated, these plates are present at the fag end of the long bones and are the last part of bone, which needs to completely harden. They are the tenderest portions of the skeletal system and so any injury to the joint most likely cause’s damage to the growth plates. Growth plate fractures are more prominent in children and young adults due to their skeletal system still being in the growing phase and their bones being quite soft and easy to break. Fracture of the growth plate can be as a result of a severe trauma to the joint of the knee or from an extremely forceful event damaging the bone in the thigh resulting in instant pain along with swelling.[2]
Treatment of Distal Femoral Growth Plate Fracture
- This condition requires instant medical attention.
- The treatment depends on how severe the fracture is.
- Further damage needs to be prevented by immobilization.
- X-ray gives a confirmatory diagnosis of how severe the fracture is.
- Imaging studies in the form of magnetic resonance imaging or computerized tomography may be required as x-rays are unable to detect cartilage damage.
- The smaller fractures can be treated successfully with casting and immobilization of the joint for some time.
- Displaced fractures are required to be put back into their place. This can be done either manually or through surgery. Post surgery, casting is required for bone healing.
- In case if acute fractures, broken parts of the bone may need to be pinned together at the time of surgery.
- When the fracture is treated successfully and healed, the patient is asked to start exercises to regain complete movement, adequate balance, and good strength.[3]