A Special Thanks to Miranda Ebraheim for assisting with this article
There are growth plates within the long bones which
contributes to the development of the bones in children.
The growth
distribution in the humerus is about 80% in the proximal and 20% in the distal
area. Displaced fractures of the proximal humerus in children are usually
treated without surgery.
In regards to the ulna, the growth distribution is about 80%
proximal and 20% distal. Growth arrest is common in fractures involving the
distal ulna and occur approximately 50% of the time. Within the radius, it is
about 25% proximal and 75% distal. Fractures at the distal radius usually heals
and corrects its angulation after a closed reduction. Surgery is rarely
necessary. Fractures involving the growth plate of the distal radius rarely
involves growth arrest.
Within the femur,
the growth rate distribution is about 30% proximal and 70% distal. Fractures
involving the growth plate of the distal femur may cause major growth
disturbances. It is expected that a child grows 1 cm per year from the distal
femur growth plate. Boys will continue to grow up until 16 years old, while
girls stop growing at the age of 14.
Finally, there are the bones of the tibia and fibula. The
growth distribution in the tibia is about 55% proximal and 45% distal. Within
the fibula, it is about 60% proximal and 40% distal.
A growth spur occurs at the time of puberty. Puberty
typically occurs in females around 8-13 years of age, and at 10-15 years of age
in males. Fractures near the growth plate remodel well.
