Growth Plate Injuries in Children's Elbows: Concerns and Solutions

Injury to the growth plate of the elbow joint?

Hello Doctor, my daughter, who is now four years old, injured her elbow growth plate in an accident last February when she was three.
It has been over a year since the surgery, and her movements are normal.
However, while her elbow looks fine from the front, it appears somewhat irregular from the side.
Is this considered a deformity? Will this condition worsen as she grows? Does she need rehabilitation? What remedial measures are available? Thank you.

tony, 30~39 year old female. Ask Date: 2012/06/04

Dr. Li Wenhong reply Orthopedics

Hello Tony, your daughter has been injured for over a year.
If there is no significant varus or valgus deformity and her movements are normal, she only needs regular follow-ups until the growth plates close.
Please return to the original treating physician for follow-up; rehabilitation is not necessary.
The description you provided, "the elbow looks fine from the front, but appears somewhat irregular from the side," is likely a phenomenon observed on the X-ray, and the detailed situation can only be assessed by a medical professional in person.
Please return to the original treating physician for follow-up.
Thank you! Changhua Hospital, Orthopedics, Dr.
Li Wen-Hong, 2012/06/06.

Reply Date: 2012/06/04

More Info

Injuries to the growth plates, particularly in children, can be a significant concern for both parents and healthcare providers. Growth plates, or epiphyseal plates, are areas of developing cartilage tissue located at the ends of long bones. They are crucial for bone growth and development during childhood and adolescence. When a child sustains an injury to a growth plate, it can potentially affect their growth and the overall shape of the bone.

In your case, your daughter suffered an injury to her elbow's growth plate at a young age, and although she has regained normal function, you are noticing some irregularities in the shape of her elbow. This situation raises several important points regarding growth plate injuries and their implications.

Firstly, it is essential to understand that growth plate injuries can lead to deformities if not properly managed. The irregular shape you are observing from the side view may indicate that there was some disruption in the normal growth pattern of the bone following the injury. In some cases, this can lead to a condition known as "growth arrest," where the growth plate closes prematurely, resulting in a shorter limb or deformity. However, if the injury was treated appropriately and the growth plate is still open, the bone may continue to grow and remodel over time.

As your daughter grows, the irregularity may not necessarily worsen, especially if her growth plate is still active. Children have a remarkable ability to heal and remodel their bones, and many minor deformities can improve as they grow. However, it is crucial to monitor her development closely. Regular follow-ups with a pediatric orthopedic specialist are recommended to assess her growth and the alignment of her elbow.

Regarding rehabilitation, whether your daughter needs physical therapy depends on her current function and any discomfort she may experience. If she is using her arm normally without pain, formal rehabilitation may not be necessary. However, if there are limitations in her range of motion or if she experiences discomfort during activities, a physical therapist can provide exercises to improve strength and flexibility, which may help in correcting any functional issues.

In terms of remedial measures, if the irregularity in her elbow becomes a concern as she grows, surgical options may be considered in the future. This could involve procedures to realign the bones or address any significant deformities. However, such decisions should be made in consultation with a pediatric orthopedic surgeon who can evaluate her specific situation and growth potential.

In summary, while the irregular shape of your daughter's elbow may be concerning, it is essential to monitor her growth and development closely. Regular check-ups with a healthcare provider specializing in pediatric orthopedics will help ensure that any potential issues are addressed early. If she is functioning well and not experiencing pain, there may be no immediate need for intervention. However, staying vigilant and proactive about her orthopedic health will be crucial as she continues to grow.

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