Growth Plate Injuries: Impacts on Limb Length and Treatment Options

Growth plate necrosis

In the case of a fourth-grade student who suffered a fracture due to a car accident, initially treated with traditional Chinese medicine for a month, the hand regained normal function but the elbow joint developed a deformity.
After consulting an orthopedic doctor, it was found that the growth plate had been displaced for a month and had since necrosed, leading to potential future discrepancies in arm length.
The patient subsequently underwent casting and rehabilitation.
To address your questions:
1.
Yes, a displaced growth plate can lead to necrosis if not properly treated, especially if the displacement persists for an extended period.
2.
In a fourth-grade child, this could indeed affect future arm length, as the growth plates are crucial for bone development.
3.
Discrepancies in limb length, known as limb length discrepancy (LLD), can occur as a result of growth plate injuries.
4.
Regarding your military service and the X-ray findings: if the X-rays show no difference in length between the two arms but you observe a significant visual difference, it may be worth seeking a second opinion or further imaging studies, such as a CT scan or MRI, which can provide more detailed information about the bones and growth plates.
5.
The report stating that the left upper limb and left upper arm are equal in length to the right arm typically includes the entire arm, but it’s essential to clarify with your physician if this encompasses the hand as well.
6.
If another hospital measured a discrepancy of four centimeters using a ruler, this suggests a significant difference that should be taken seriously.
It may be beneficial to consult with an orthopedic specialist who can evaluate both the clinical findings and imaging results to provide a comprehensive assessment.
In summary, it is advisable to seek further evaluation from a specialist who can address your concerns about limb length and the implications for your future.

A Jie, 20~29 year old female. Ask Date: 2022/12/30

Dr. Wang Shouji reply Orthopedics

Hello, generally speaking, limb length discrepancies are not related to military service; however, the range of motion and angular deformities may be associated with it.
If there is an injury to the growth plate on one side, it can lead to uneven development on both sides, resulting in angular deformities.
If you have any questions, you can consult at a military hospital.
Changhua Hospital cares about your health.
Wang Shou-ji.

Reply Date: 2022/12/30

More Info

Understanding growth plate injuries is crucial for assessing their impact on limb length and determining appropriate treatment options. Growth plates, or epiphyseal plates, are areas of developing cartilage tissue near the ends of long bones in children and adolescents. They are responsible for bone growth and elongation. When a growth plate is injured, it can lead to complications such as growth disturbances, limb length discrepancies, or deformities.

In your case, the concern about a growth plate being misaligned for a month and subsequently "dying" is significant. Growth plates can indeed be vulnerable to injury, and if not treated properly, they can suffer from avascular necrosis, where the blood supply is compromised, leading to the death of the bone tissue. This can result in permanent growth disturbances, including the potential for one limb to grow shorter than the other.

Regarding your question about whether a month of misalignment can lead to the growth plate's death, it is possible. The longer the growth plate is misaligned, the greater the risk of complications. If a growth plate is damaged, it may not only affect the growth of that specific bone but can also lead to issues in the surrounding bones and joints. In your situation, the concern about a "short arm" or limb length discrepancy is valid. If the growth plate has been compromised, it could affect the future growth of the arm, potentially leading to a noticeable difference in length.

You mentioned that X-rays show no difference in length between your arms, but you observe a significant visual discrepancy. It's important to understand that X-rays measure bone length, while visual assessments can include soft tissue and muscle development, which may not be reflected in X-ray images. The term "upper limb" in medical reports typically refers to the entire arm, including the hand, but it is essential to clarify with your healthcare provider whether the measurements included the hand and wrist.

If you are experiencing a noticeable difference in arm length, and this is not reflected in X-ray findings, it may be beneficial to seek a second opinion from an orthopedic specialist who specializes in pediatric or adolescent injuries. They can perform a thorough examination, possibly including additional imaging studies, to assess the growth plates and overall limb alignment.

In terms of treatment options, if there is a confirmed growth plate injury with a risk of limb length discrepancy, various interventions may be considered. These can range from physical therapy to surgical options, such as growth plate stimulation or limb lengthening procedures, depending on the severity of the injury and the expected growth potential.

In conclusion, growth plate injuries can significantly impact future limb length and function. It is essential to monitor the situation closely and consult with specialists who can provide tailored advice based on your specific circumstances. Regular follow-ups and imaging studies will help ensure that any potential issues are addressed promptly, allowing for the best possible outcome in terms of growth and function.

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