Growth Plate Injuries of the Lower Extremity: Case Examples and Lessons Learned

BACKGROUND: The presence of growth plates at the ends of long bones makes fracture management in children unique in terms of the potential risk of developing angular deformities and growth arrest. MATERIALS AND METHODS: We discuss three distinct cases depicting various aspects of physeal injury of the lower extremity in children. RESULTS: The case illustrations chosen represent distinct body regions and different physeal injuries: Salter–Harris II fracture of the distal femur, Salter–Harris VI perichondrial injury of the medial aspect of the knee region, and Salter–Harris III fracture of the distal tibia. The clinical presentation, pertinent history and physical findings, imaging studies, management, and subsequent course are presented. CONCLUSIONS: Growth plate injuries of the lower extremity require a high index of suspicion and close monitoring during skeletal growth. Early recognition and proper management of these injuries can minimize long term morbidity. The treatment plan should be individualized after a comprehensive analysis of the injury pattern in each patient. Establishing a long term treatment plan and discussing the prognosis of these injuries with the child's caretakers is imperative.