Acute Bone Injuries
Broken bones account for only one in twenty sports injuries overall. The rate for young people is lower still, as their skeletons are more resilient than adults’ and less susceptible to fracture. Growth-plate injuries and avulsion fractures, explained below, are unique to the teenage years.
Through late puberty, the ends of the long bones continue to lengthen, widen and change shape. An epiphysis is a growth plate that contributes to the growth of long bones and the formation of a joint surface. An apophysis is a growth plate that serves as an attachment site for a tendon or ligament. During growth, the epiphysis and the apophysis may be more susceptible to injury than the related ligament or tendon. Because of this, growth-plate injuries are easily confused with sprains or strains. A youngster with a suspected sprain should always be evaluated for possible epiphyseal or apophyseal injury.
In teens, muscle-tendon units are often stronger than the growth centers (apophyses) to which they are connected. An avulsion fracture occurs when the muscle and tendon exert so much force that they tear away (avulse) the apophysis. Apophyseal avulsions commonly occur around the knee and the pelvis.