Hooper N, Johnson L, Banting N, Pathy R, Schaeffer EK, Bone JN, Zomar BO, Sandhu A, Siu C, Cooper AP, Reilly C, Mulpuri K. J Clin Med. 2024;13(10):2946. DOI: 10.3390/jcm13102946
Abstract
Background:
Physeal (growth plate) fractures make up 18–30% of paediatric fractures and can lead to growth arrest. It’s hard to predict which ones will. This prospective study looked for factors linked to arrest.
Methods:
Patients 18 or younger with open growth plates and a long-bone physeal fracture were enrolled within four weeks of injury at BC Children’s Hospital. Data were collected at baseline, during healing, and at one and two years. Two blinded paediatric orthopaedic surgeons reviewed the radiographs, with a third resolving disagreements.
Results:
Of 332 patients with adequate follow-up, 100 (30.1%) developed growth arrest, higher than past reports. Those patients were older (12.8 vs 9.4 years). Age and operative fixation significantly raised the odds of arrest. Distal femur fractures had the highest rate (86%), followed by proximal tibia (50%), distal tibia (45%) and proximal humerus (43%).
Conclusions:
Arrest was more common in older children and lower-limb fractures. Most cases needed no further treatment. The true incidence may be lower than 30.1% because diagnostic criteria vary and many patients were near skeletal maturity. Loss to follow-up and the use of plain radiographs were limitations. The authors call for a larger multicentre study to build a prediction model.
