Growth Plate Injuries in Children and Adolescents: A Narrative Review of Mechanisms, Risk Factors, and Clinical Implications

Abstract— Growth plate injuries are common in children and adolescents, particularly in those engaged in sports or high-impact activities. Due to the unique anatomy and physiology of the physis, these injuries can lead to growth disturbances, angular deformities, and limb length discrepancies if not appropriately diagnosed and managed. This narrative review summarises current evidence regarding the mechanisms, risk factors, clinical presentation, diagnostic strategies, and treatment options for growth plate injuries. Both non-operative approaches, such as rest, immobilisation, and physical therapy, and operative interventions, including physeal-sparing techniques and epiphysiodesis, are discussed. Emerging therapies, including stem cell applications and growth modulation, are also highlighted. Emphasis is placed on early detection, load management, and education of athletes, parents and coaches to minimise long-term complications. Understanding the epidemiology, biomechanics, and management of physeal injuries is essential for optimising functional outcomes and ensuring safe participation in athletic activities. Keywords— growth plate, physeal injury, children, adolescents, Salter–Harris classification, pediatric orthopaedics, sports-related injury, skeletal development