Ankle injuries are some of the most common injuries for active children, especially those who participate in organized sports. For children whose bones have yet to reach skeletal maturity, around age 14 to 15 for girls and 16 to 17 for boys, injury to the ankle growth plate or a fractured growth plate in the ankle is a common occurrence. If left untreated, this can result in poor healing and negative long-term effects.
When approaching adulthood, the cartilage that composes ankle growth plate fuses. Therefore, for older teenagers and adults, an injury to the ankle may mean only an ankle sprain. In contrast, in younger children, because the developing growth plate in the ankle is weaker than the surrounding ligaments, the same sprain in a child may lead to an injured or fractured ankle growth plate.
Different Types of Ankle Growth Plate Injuries
While most fractured growth plates in the ankle often heal without complications, some injuries necessitate special attention in order to ensure normal growth continues.
Ankle growth plate injuries most commonly either occur at the end of the fibula or tibia, two of the three bones that compose the ankle joint.
- Growth plate fractures in the ankle that occur at the end of the fibula, commonly associated with a typical ankle sprain, may not present on an X-ray. These often require about four to six weeks of recovery.
- A fractured or broken growth plate in the ankle at the end of the tibia may be more severe, and may require more time to heal (up to 3-4 mo).
Symptoms of an Injured Ankle Growth Plate
Because ankle growth plates can be difficult interpret on an X-ray, the difference between a simple ankle sprain and a fractured ankle growth plate can be challenging to diagnose. Often an pediatric orthopedic specialist may need to assist with diagnosis. Common symptoms include:
- Pain, swelling and tenderness
- Bruising and misshaped appearance
- Inability to bear weight
- Tears or open skin wound
If your child is presenting any of the following symptoms, it is important to seek treatment within the first few days (preferably hours) of the injury to ensure proper treatment and a lower risk for long-term damage.
Treatment Options for Ankle Growth Plate Injuries
Treatment methods for an injured or broken growth plate in the ankle depend on both the severity and the location of the injury. While all ankle growth plate injuries will require your child to limit the amount of weight he or she bears on the injured ankle, the severity and location of the injury can dictate the length of treatment.
For a moderate ankle growth plate injury at the end of the fibula, treatment usually involves four to six weeks in a cast or walking boot followed by supervised activity for a few weeks to regain strength.
An injury at the end of the tibia usually requires more healing time, requiring a cast or, corrective surgery for more serious fractured growth lates in the ankle.