A fracture in a child can be very different from a fracture in the same location in an adult. If the fracture involves the ends of the bone, the growth plate may be involved.

The growth plate is a very metabolically active region of the bone and represents the location of continued growth of that individual bone. Occasionally there can be a disturbance of the normal growth resulting in a bone shortening, or angulation.

The good news is that although fractures often involve the growth plate, rarely is it a problem. The physician will inform you if the fracture involves the growth plate and often will inform you of the potential of a growth plate problem, depending on the type and site of the injury.

Salter-Harris fractures are epiphyseal plate fractures and are common and important as they can result in premature closure and therefore limb shortening and abnormal growth. They represent approximately 35% of all skeletal injuries in children, and typically occur in the 10-15 year old child.

The growth plate has 5 distinctive zones. Fractures tend to propagate along the weakest zone, which is the spongiosum. Fortunately this is not a region of active growth, and therefore fractures through this area have a good prognosis. When the fracture passes towards the epiphysis, it passes through the zones of proliferation and reserve which result in possible premature closure of the growth plate at the fracture site.