The bodies of kids are growing and changing rapidly and this includes certain parts of their bones. 

Growth plates are the softest and weakest sections of the skeleton and are decisive for the physical growth of children and teenagers. They are also vulnerable body parts to injuries and fractures.

What is a growth plate and where are growth plates located?

The growth plate, also known as epiphyseal plate or physis, is the area of growing tissue near the ends of our long bones.

The long bones of the body do not grow from the center outward. Instead, growth occurs at each end of the bone around the growth plate.

During childhood, the epiphyseal plate matures and its total width decreases. Eventually, it disappears at the end of puberty with complete replacement by bone along with the cessation of longitudinal growth. 

There are at least two growth plates on each end of the bones - for example in the shoulder, elbows, wrists, vertebrae, pelvis, thighs, ankles, heels, fingers, and toes.

The epiphyseal plate consists of cartilage, which is a rubbery, flexible material. The nose, for example, consists of the nasal bone, the upper lateral cartilage, and the lower lateral cartilage. 

Bone fractures & growth plate injuries

As the cartilages are the weakest elements of a child's skeleton, they are vulnerable to injuries, or so-called fractures.

Fractures gradually occur as a result of repetitive stress on the bone, which can especially to kids that are doing sports regularly. Epiphyseal plate fractures are also often caused by a single event, such as a fall or a car accident.

All children who are still growing are at risk for growth plate injuries. Surprisingly, growth plate fractures occur twice as often in boys as in girls, because girls mature at an earlier age than boys.

Most growth plate fractures occur in the long bones of the fingers, in the outer bone of the forearm (radius), and the lower bones of the leg (the tibia and fibula).

When do teenagers stop growing taller?

As soon as teenagers stop growing, the epiphyseal plates' width decrease and harden into solid bones. This phenomenon occurs usually by the end of puberty, although the exact time is different for each individual.

Girls tend to reach skeletal maturity earlier than boys. Their growth plates usually fuse, or close around ages 13 to 15, while boys' epiphyseal plates close later, at around ages 15 to 17.

The reason for this difference is that a girl's puberty typically starts about 2 years earlier than a boy's. In elementary school, for example, girls are often taller and more mature than boys because of being earlier in puberty.

How can parents check their kid's growth development?

In a safe and painless procedure, doctors can check the maturity of a child's skeletal system by performing an x-ray examination on the left wrist, hand, and fingers.

The results are compared with a register of x-ray images, that are based on a large number of other kids of the same gender and age.

The growth plates are easily detectable on the x-ray images as they are softer and contain less material, making them appear like dark lines on the end of the bones. 

Based on the appearance and thickness of the epiphyseal plates on the x-ray images, the doctor can assess the development of a child's growth process.

The test is usually ordered by pediatricians to help diagnose conditions that delay or accelerate physical growth and development.

Once the growth process of adolescents is completed, the growth plates have solidified into bones and the dark line will no longer be visible on an x-ray.

At this stage no further longitudinal bone growth is possible. Solely, the compression of the discs in the spine can lead to small height increases during adulthood.

Frequently Asked Questions concerning growth plates:

• Can I check the status of my kid's growth plate development in a self-test?

There are many unreliable sources for doing self-diagnosis of the growth plates on the Internet. The best method to accurately check the current status of your kid is to ask a pediatrician to perform an x-ray examination.

• How can a growth plate fracture occur?

Most growth plate fractures occur because of stress on the bones, often caused by doing sports such as basketball, football, soccer, skiing, skateboarding, or by traffic accidents. Interestingly, boys suffer almost twice as many fractures than girls because girls grow faster and their bones harden quicker.

Signs and symptoms of a growth plate injury are usually the same as for broken bone. They include the inability to put weight or pressure on the limb, pain or discomfort, and inability to move the limb. 

• Do kids grow normally when their growth plate is fractured?

Most epiphyseal plate fractures heal quickly without any complications. In few cases in which the growth plate is crushed or badly fractured, it may harden, or close early.

Most kids who are treated for growth plate injuries do not have any long-term complications. However, follow-up care is important to make sure bones are healing and continuing to grow normally.

Conclusion

Because of the soft nature of growth plates, these parts of the bones are vulnerable to injury during the development of a child. If children or teens show any symptoms of epiphyseal plate injury, they should see a doctor for evaluation.

The timing and speed of a child's physical development can vary a lot, but it's important to understand that no further longitudinal growth is possible after the growth plates have closed.

Therefore, parents should make sure that their kids get a sufficient intake of important nutrients, exercise, and sleep before their epiphyseal plates fuse. Follow these 6 tips to keep your kid's bones healthy.

References

Emons J, Chagin A, S, Sävendahl L, Karperien M, Wit J, M (2011, June). Mechanisms of Growth Plate Maturation and Epiphyseal Fusion. Horm Res Paediatr;75:383-391. Retrieved from: https://www.karger.com/

Johns Hopkins All Children’s Hospital. Growth Plate Injuries. Retrieved from: https://www.hopkinsallchildrens.org/

Mayo Clinic (2019, March 13). Growth plate fractures. Retrieved from: https://www.mayoclinic.org/

NIH National Institute of Arthritis and Musculoskeletal and Skin Diseases. Growth Plate Injuries. Retrieved from: https://www.niams.nih.gov/

OrthoInfo (2014, October). Growth Plate Fractures. Retrieved from: https://orthoinfo.aaos.org/

Rocky Mountain Hospital for Children. Growth Plate Fracture. Retrieved from: https://rockymountainhospitalforchildren.com/