Sports-related Fractures by Richard Lu, MD
Recently, we have noticed an increasing number of sports related injuries at our clinic, most of which happened to teenagers active in different team sports, such as basketball, baseball and football. An increase in pediatric sporting events has been attributed to the increase in pediatric sporting injuries that we witness. There are nearly 3 million emergency department visits annually for pediatric-related sports injuries and that number is still on the rise.
One of the major challenges that we face in the diagnosis of acute fractures in kids is the presence of growth plates, which can mimic subtle hairline fractures. Salter Harris fractures refer to the acute fractures that involve the growth plates in skeletally young patients. Salter-Harris fractures are classified into five different types. Type I fractures are fractures through the growth plate. On radiographs, a fracture usually will not be seen. It is common to see some widening of the affected bone. Type II fractures involve one side of the growth plate. Type III fractures involve the other side of the growth plate. Type IV fractures involve both sides of the growth plate. Type V fractures are due to a compression injury of the gap between the growth plates. There will often be an absence of the normal gap of the growth plates on radiographs for Type V fractures.
The goal in treating Salter-Harris fractures is to realign the anatomic growth plate so the bone can keep growing. The risk of bone growth failure increases with Salter-Harris classification. Types I and II fractures usually can be treated with immobilization (placing a cast or brace). In instances where the fracture is displaced, closed reduction (manipulation) may be necessary, followed by immobilization with a cast or brace. Rarely is open surgery needed. Types III, IV, and V fractures usually require orthopedic intervention to avoid growth problems. These patients must be followed long-term to assess for growth problems. It is important in all sport injuries where a potential fracture has occurred to see a medical professional and consider X rays.
The information provided is for general interest only and should not be misconstrued as a diagnosis, prognosis or treatment recommendation. This information does not in any way constitute the practice of medicine, or any other health care profession. Readers are directed to consult their health care provider regarding their specific health situation. Marque Medical is not liable for any action taken by a reader based upon this information.