Do you think it’s reasonable to X-ray a child’s knee every week for a month or more to monitor a fracture of the growth plate near the knee? We are very concerned about exposure to the X-rays.

Experts in orthopedic medicine do advise monitoring for complications and especially for growth arrest for up to 12 months following a distal femur fracture in children who have not reached their full growth yet. Fracture position is also monitored with serial X-rays (taken weekly) during the first eight to 10 weeks. Any sign that the fracture is not healing or healing in a misaligned position is an indication that surgery is needed.

Every effort should be made to line up the joint surface during treatment for fractures of the distal femur. This will reduce the risk of growth arrest and/or the development of posttraumatic arthritis in young children who have not yet reached full skeletal maturity (i.e., they are still growing). Patients must be closely monitored for any potential complications including infection, loss of reduction (the fracture opens up again), loss of blood supply, and of course, growth arrest.

Any fracture affecting the growth plate of bones in children can result in stopping growth. Disturbance of growth after fracture of the distal femur (bottom end of the thigh bone just above the knee) is a particularly vexing problem. That’s because this is where the fastest growth plate in the body is located. Young children can experience as much as a three-inch difference in leg length from a fracture of this type.

In addition to creating a difference in leg length from one side to the other, growth arrest affecting the distal femur can cause a change in the angle of the knee. Later, posttraumatic arthritis can occur because of the affect of the fracture on the joint itself. That’s why weekly X-rays are taken in an effort to monitor and prevent any of these potentially serious problems from developing.