Parents Questions: Growth plate injuries

[Mish]

OK, I'll try to keep it short. This is a half vent, half question. In a nutshell, DD 9 y.o., lv 6 was at practice, waiting her turn to go. Her turn comes, she can't even take another step forward. They were doing stuff on tumble track right before but no apparent "ouch" moment. Xrays indicated no clear break but were indicative of possible growth plate fractures (stress, compression). Tender to touch, very slight swelling. 3 weeks in a cast with zero weight bearing. DD going for conditioning during this time, but starting to get antsy.

So... we were under the impression at the 3 week mark she would get cast off and then SLOWLY begin to resume activity, maybe with taped ankle or brace. No go. 3 more weeks in knee to toe boot with no weight bearing at all. She has no pain to the touch or moving it around. There is nothing on the Xray. My sweet, lovely DD who has never even had a tantrum as a toddler had a full-blown melt down right there in doc's office. Hysterical crying, refused to leave, the whole thing. Felt so bad for her. She is already missing the first in-house meet and is frustrated bc the girls are learning the lv 6 routines and she is not. Not to mention this lovely weather in the NY area during recess that she's missing. Plus the crutches 24/7 are starting to get old!

My question is for those who are familiar with this injury. Is this typical? I know that erring on the side of caution with growth plate injuries is common, but is this overly cautious? Of course we don't want to rush it just to get hurt again (not a CGM!), but we have seen other girls with similar injuries with a walking boot, tape, etc. She thought for sure she would be able to start doing bars, and just wants to be able to do a little bit of learning the routines, just the dance and marking them, etc. Plus, this boot is *%$#%&# heavy! She has a tiny leg and I don't see how she will condition with it. I'd rather just get the cast back on for another 3 weeks.

Some are telling me to go for a second opinion, but I thought I would start with the wealth of knowledge here. Sorry, I tried to keep it short, but I failed!

 

[raenndrops]

I would go for a second opinion. 6 weeks of non a weight bearing for a POSSIBLE growth plate fracture seems a little much. A pediatric sports medicine ortho would be a good second opinion.

 

[IreneKa]

I agree, seems excessive! DD just had a similar injury on her wrist over the summer. No break on x-ray, but because it's a growth place there could be a fracture, so cast for 3-4 weeks (we did 3), then wrist brace for another 3 weeks. But with the brace she was allowed to do anything as long as it didn't hurt. Of course she is not doing gymnastics anymore, I'm pretty sure if she did she wouldn't be allowed on bars yet. But still.. 3 more weeks with no weight bearing at all? Even with the boot? What's the point of a boot then?
So, yeah, I vote second opinion.

 

[duyetanh]

Second opinion. And you definitely do not want that cast back on. Boot gives mobility, ability to ice, and do pt.

 

[Mish]

Thank you! You guys rock!!

 

[Jenny]

She's 9 and level 6. 6 months out wouldn't make any difference in the long run. Get a second opinion to check but don't rush back.

 

[B&M's mom]

If you are not working with a pediatric sports medicine doc, then you may want a second opinion. Of course, getting that appointment may take more than the 3 weeks. But breathe, you are correct, rushing back is probably not in your daughter's best interests. Your daughter is young and you really really don't want injuries that linger for years. Trust me on this one! Only your doctor knows whether this injury can have a long term impact. Also, the fact that she didn't have an event giving rise to the accident may be causing some concern. The problem with comparing her injury to others is that you don't know what exactly the other girls' injuries were, where or how bad. Remember gymnastics is a marathon, not a sprint so letting her body fully heal before going back is in her best interests long term.

 

[Mish]

If you are not working with a pediatric sports medicine doc, then you may want a second opinion. Of course, getting that appointment may take more than the 3 weeks. But breathe, you are correct, rushing back is probably not in your daughter's best interests. Your daughter is young and you really really don't want injuries that linger for years. Trust me on this one! Only your doctor knows whether this injury can have a long term impact. Also, the fact that she didn't have an event giving rise to the accident may be causing some concern. The problem with comparing her injury to others is that you don't know what exactly the other girls' injuries were, where or how bad. Remember gymnastics is a marathon, not a sprint so letting her body fully heal before going back is in her best interests long term.

Yes. of course. I do not want her rushing back just to get injured again. The total of 6 weeks with absolutely no weight bearing seemed overly cautious to me. If that's what it is then fine, just wanted to see what others thought and if I should get second opinion. Thank you!

 

[Clover]

We've had experience with this injury. Seems excessive to me (not a doctor). Definitely take her to a sports med doctor for a second opinion.

 

[duyetanh]

Yes, everyone's injury is different. I agree that it is weird how it happened, but it could have happened a few min before and then decided to flare up, so to speak. I am so sorry. Injuries are so hard for everyone!

 

[BachFlyer]

Currently dealing with a fracture at growth plate in my dd's ankle. We've been told 4 weeks in boot non weight bearing at minimum, and assuming next xray comes back clear and if she can put weight on it after the first 4 weeks without pain, she will have another 4-6 weeks with the boot but weight bearing. Growth plates have an extreme amount of stress on them so it's best to be cautious, according to the osteopathic surgeon we are working with - he specializes in below the knee injuries and sees gymnasts every day so I am going to trust his judgement.

When dd broke her foot a few years ago (it was a clean fracture without dislocation), she was in a boot NON-weight bearing for 7 weeks. That doc said non-weight bearing for that long is the most agressive way to heal the injury, even after it stopped hurting, because the pressure on it just makes the healing take longer than it needs to. After 7 weeks, he said she was good and she walked out of his office she with no weight bearing transition, and began easing back into practice.

Just our experience, of course no substitute for the doctor!

 

[Mish]

Thanks everyone. We are seeing a Ped. Sports medicine guy Monday. Just want to see someone with more experience with this type of injury. Of course we will do whatever is most prudent!

 

[sce]

First, which body part? Second you did not say that the xray was clear, you said no apparent break but indicative of stress fractures. That is not clear. I do agree about seeing a sports doctor and hopefully string pt, but the time off might still be necessary.

 

[wrzos]

My dd had a pretty much definite growth plate fracture in an ankle (forget which one right now) with a similar approach that you are getting - cast, then boot. When we went back for subsequent issues (Severs') the new Ortho (pediatric) and I chatted about the prior treatment which I thought excessive, and he agreed. Made mention of how immobilizing the ankle during recovery was "old school". That said, I wouldn't out and out question the treatment, but I would get a 2nd opinion...

 

[Mish]

My dd had a pretty much definite growth plate fracture in an ankle (forget which one right now) with a similar approach that you are getting - cast, then boot. When we went back for subsequent issues (Severs') the new Ortho (pediatric) and I chatted about the prior treatment which I thought excessive, and he agreed. Made mention of how immobilizing the ankle during recovery was "old school". That said, I wouldn't out and out question the treatment, but I would get a 2nd opinion...

Thanks for the info! There is no evidence of a break on xrays which leads them to believe this is a compression fracture. This new doc is supposed to specialize in this type of injury, so we shall see. I certainly do not want to be back in this situation (or worse) a few weeks down the road, but just want to get more exact info. DD would love to be cleared for bars, with spotting, at least! Thanks!!!

 

[UnoMas]

My DD had a suspected fracture at the growth plate of her wrist. She was in a hard brace for 7 weeks, and no bearing weight on wrist for 9. 6 weeks in a cast/brace seems standard for any fracture, even suspected. A second opinion can't hurt. My DD has had a tantrum in doctors' offices before too!

 

[gymmutti]

DD has a growth plate fracture in tibia (X-ray was clear but MRI clearly showed it). We know she'll be non-weight bearing for awhile BUT after 1 week in an immobilizer brace they moved her to a hinged brace so to allow for PT on range of motion. Good luck on Monday!