PEDIatric Foot & Ankle Sprains May Be a More Complex Growth Plate Injury

By Dr. Carlo A. Messina

Injuries to the growth plate in children may cause damage to the structures at the end of the bone that will allow the child’s bone to grow to full adult size. X-rays can fail to provide a complete and accurate picture of the diagnosis. These injuries may be misdiagnosed as a simple sprain of the foot or ankle. However, a more complex injury may be present.

Growth plates, which start to close between the ages of 13 and 18, can be damaged in incidents such as simple falls, sports injuries, automobile accidents or other major or minor trauma. If not recognized and treated early, a child’s growth plate injury can lead to shortening of the bone (growth ceases) as the growth plate may close prematurely. Angular deformities of the bone (a curve) may also develop. The severity of these deformities depends on the age at the time of injury, extent of the injury and the part of the growth plate that has been damaged. Certain portions of the growth plate may be injured affecting its growth while other parts grow more normally thus causing a bowing of the bone.

Symptoms of a growth plate injury may mimic a sprain. These injuries occur more frequently than realized. There will always be pinpoint tenderness on the bone’s growth plate and a degree of swelling that is proportional to the degree of injury to the area. The child will often limp and try to avoid the body part. Normal treatment for a sprain may involve simple observation and application of an ace bandage or brace. This treatment for a growth plate injury that is severe may be devastating.

X-rays are used to evaluate bone and joint alignment. A growth plate can be injured or even fractured with a normal X-ray. In more moderate to severe cases, x-rays will usually show the fracture. When in doubt, a CT scan may be necessary.

Treatment options include:

1. Immobilization in a below-theknee cast with or without crutches may be necessary if the growth plate is well aligned. These injuries will heal on their own within six to eight weeks. The younger the child, the faster it heals.

2. If the injury has caused misalignment of the growth plate it can sometimes be carefully manipulated back into place and then protected with a cast. The cast would be necessary for a minimum of six to eight weeks. Non-weight bearing would be mandatory.

3. If the misalignment is more severe and not able to be manipulated back into its normal position, surgery would be necessary to restore the growth plate to its proper position. This may help avoid later problems including malalignment or premature growth plate closure that may cause the extremity to be shortened and crooked.

The most important thing is immediate diagnosis and treatment.

▸ Carlo A. Messina, DPM, is a Board Certified Reconstructive Foot and Ankle Surgeon, Diplomate American Board of Foot and Ankle Surgery. He is a Foot and Ankle Surgeon with the Foot, Ankle and Leg Specialists of South Florida and specializes in treating infants, children, teens and adults. The South Florida Institute of Sports Medicine in Weston is located at 1600 Town Center Blvd., Suite C, (954) 389-5900 and in Pembroke Pines at 17842 NW 2nd Street, (954) 430-9901. www.SouthFloridaSportsMedicine.com

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ORTHOTICS $400 | CASTS $200 | LACERATION REPAIR $550 ndeed, it is true that people learn foreign languages for various reasons such as work, study, relocating to new countries, or simply for personal satisfaction. Through this process, individuals gain a multicultural perspective and become more compassionate, fostering connections with diverse people worldwide. However, have you ever considered the profound impact that studying a new language has on the brain?

Learning a new language brings about changes in the brain, which has been proven by research studies. The process of acquiring a foreign language has fascinating effects on the neurological aspects of the brain. Through the use of MRI technology, experts have been able to compare the brain functions of individuals who are monolingual with

By Dr. Katya Pizarro, Founder, ESL & Higher Education

Ithose who are bilingual. The findings indicate that bilingual individuals have a greater number of connections between neurons, known as grey matter, which includes the cell body and dendrites. Additionally, bilingual brains exhibit changes in the white matter, a nerve system that connects the brain's four lobes. This promotes faster learning and increased memory capacity, along with improved focus, attention, and executive functions. Furthermore, the constant filtering of linguistic information during the foreign language learning process has been found to reduce the risk of developing neurological conditions like Alzheimer's disease. Moreover, the benefits of learning a second language extend beyond neurological effects. Second-language learners experience enhancements in academic performance, communication skills, and creativity. These benefits are not limited by age, as learners of all ages can engage in effective brain workouts by acquiring new words, grammatical constructs, and building upon existing knowledge. Consequently, studying a new language strengthens brain signals and elevates cognitive abilities. Bilingualism and biculturalism are not only associated with personal and social virtues, but they also offer impressive neurological advantages.

Acquiring a foreign language is an invaluable skill that persists throughout one's lifetime, providing consistent neurological benefits regardless of age. Speaking a new language is a cognitive exercise that fuels the brain's capabilities.

▸ Dr. Katya Pizarro is the Founder and President of Elite Language Academy (ELA), a hybrid-virtual language center in the USA. As an innate educator, she lectures as a Professor at Broward College in Florida. Her research interests and publications relate to TESOL education, multiculturalism, schooling settings with ESL students, and professional development.