[Health Tip] Our Child Hurt While Playing... Could There Be Any Growth Issues?

When a child playing actively suffers a bone fracture, parents' biggest concern is whether the injury might affect the child's growth. In fact, about 20% of fractures in children are known to involve damage to the growth plate.

Children visiting Gwanghwamun Square in Seoul are playing in the fountain. Photo by Dongju Yoon doso7@

However, most growth plate injuries heal well without complications if treated properly, allowing for normal growth. Seungchul Kang, a professor of pediatric orthopedics at Seoul Asan Medical Center, said, "there is no need to worry automatically just because there is a growth plate injury. If it is determined that a child has injured the growth plate, the first priority is to check the child's bone age and assess how much growth remains," he advised.

If the fracture is located only on the diaphyseal side of the bone relative to the growth plate, there is a high possibility of normal growth. However, if the fracture completely crosses the growth plate or involves the area distal to the diaphysis, the likelihood of impaired growth increases. The growth plate around the elbow has limited remodeling capacity, so it is important to properly align the bone. The shoulder and wrist have greater remodeling ability, so if there is significant growth remaining, good outcomes can often be achieved without surgery. Additionally, whether the joint is involved and whether the fracture is aligned with the direction of joint movement can affect the treatment plan, so consultation with a pediatric orthopedic specialist is necessary.

Fractures in children often differ in pattern and treatment from those in adults. While adults are more likely to have complete fractures or comminuted fractures where the bone shatters into pieces, children often experience microfractures with tiny cracks or incomplete fractures where the bone bends without fully breaking. Such fractures can be difficult to detect unless examined by a well-trained pediatric orthopedic specialist. Sometimes, children receive a diagnosis of "normal" at a local clinic but continue to experience pain and swelling, and only upon returning to the hospital later is the fracture diagnosed.

Microfractures may not show any abnormalities on initial X-rays, but over time, the healing process can be seen as bone resorption on follow-up X-rays. If a child continues to complain of pain, has difficulty walking or moving an arm, or shows swelling after an injury, even if a fracture was not initially diagnosed, it is advisable to protect the area with a splint and have the child re-examined after some time.