I?m sorry to hear about your son?s accident. Children, sadly, are
prone to this type of accident. However, from my research, the outcome
looks good for your son.
The word you are referring to is either ?diaphysis? ?epiphysis?, or
?metsphysis?. ?A fracture of the epiphysis and physis - growth plate -
presents a special problem because fractures at these sites may result
in the abnormal growth of bone ends. This type of injury is most often
seen in boys and has a peak incidence in infancy and between 10 and 12
years of age.?
?Diaphyseal Fractures - Children's bones are elastic. Therefore, when
put under a stress, a child's bone will first bow (a bowing fracture),
then fracture through one cortex (a torus / greenstick / buckle
fracture), and then finally fracture through both cortices (complete
Metaphyseal - Epiphyseal Fractures - Children's ligaments are stronger
than their bones. Thus, when a stress is placed on the end of a bone,
instead of getting a ligament tear like an adult, a child gets a
fracture of the metaphyseal-epiphyseal portion of the bone (Salter
?The epiphyseal plate (physis) is the growth cartilage of the long
bones of children. It is most frequently injured after the age of 10.
Physeal injuries have been reported to account for between 15% and 30%
of all skeletal injuries in children. One study suggested that 15% of
these injuries result in physeal arrest. Another study, however,
demonstrated that proper therapy of these injuries reduced the
incidence of physeal arrest to 1.4%. The generation of the fracture
line through the growth plate is used to categorize fractures using
the Salter-Harris Classification System described in 1963.?
?Type II injuries occur most often in children older than 8 years of
age and involve a fracture line that passes through the epiphyseal
plate; the epiphysis is laterally displaced, tearing the periosteum on
one side while leaving it intact on the side of the metaphyseal
fracture. Type II fractures are easily reduced due to the intact
periosteum on the fracture side. Because circulation to the epiphysis
remains intact, the prognosis for growth is good. Displaced Type I or
II fractures that require reduction are treated with complete limb
splint for 6-8 weeks.?
?Children?s bones heal quickly and well. Most fractures will heal on
their own with simple immobilization in a cast or splint. Some
fractures, such as those in the fingers or toes, might heal well with
only ?buddy taping? (taping the broken digit to one next to it for
Occasionally fractures need to be ?set? to realign the bones. Surgery
is sometimes needed, either to align the bones or to stabilize them.
This is much less frequent in children than in adults.?
According to eMedicine, much of the outcome depends on the skeletal
maturity of your son. This page also gives some good advice ?As in
any surgical procedure, multiple opinions exist, but long or short
casts, removal of metalwork, and other aspects are always based on the
individual surgeon's preference and teaching. The recommendations of
this article are based on several leading pediatric orthopedic
surgical books that outline the above management as the safest and
Children?s foot fractures
Illustrations (epiphyseal fractures of the leg):
I hope this has helped you understand more about foot fractures.
Because this is general information, I urge you to discuss your son's
outcome with the orthopedist for more information about your son's
particular injury. Wishing your son a speedy recovery!
Epiphyseal foot fractures + children
Pediatric foot fractures