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Sports, Orthopedics, and Spine

Besides Dr. John Masterson, the physicians practicing at Sports, Orthopedics and Spine are Dr. Keith Nord, Dr. David Yakin, Dr. Brad Wright and Dr. Stephen Houseworth. The clinic is at 569 Skyline Drive.

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Treating orthopedic injuries in children

Dr. John Masterson tells 10-year-old JP Boyd that his leg is healing nicely, and the cast can come off

A typical 10-year-old boy, JP Boyd goes at life full throttle, with little stopping him. What seemed like a fun idea in gym class, though, slowed him down for awhile as it turned out not to be such a great idea. “I just wanted to jump up and touch the basketball net,” says JP. “Who would have thought I would land on a girl and turn my ankle.”

JP went to Dr. John Masterson at Sports Orthopedics and Spine, hoping to learn that all he had done was sprain his ankle. The x-ray did not indicate a fracture, but the location of the pain, bruising and tenderness in JP’s ankle told Dr. Masterson a different story. JP had suffered an injury to the growth plate in his ankle, which for a growing 10 year old can be a significant injury. He left the clinic with a cast on his leg so his ankle could heal.

Treating children with orthopedic injuries is different than treating adults, says Dr. Masterson, who is board certified in orthopedic surgery and sports medicine. “Kids are kids and as such we see some injuries in them that we do not see in adults. Children also are still growing and that can change the dynamics of treatment from that of an adult.”

One concern is growth plates, weaker areas at the end of the bone because they are not yet solid bone and which can be susceptible to injury during childhood and adolescence. The growth plate determines how long the bone will be.

“Children have growth plates on pretty much every bone,” says Dr. Masterson. “Each one closes at a different period in a child’s life. Unfortunately, until they do close, they are prone to injury and are one of the more common injuries we see in kids.”

With children, many times what is perceived to be a ligament injury is really in an area where the child has an open growth plate, says Dr. Masterson. Injuries that might cause a sprain in an adult could be a growth plate fracture in a child.

Boys are twice as likely to have growth plate fractures because girls’ bodies tend to mature at an earlier age, meaning their bones stop growing sooner and become stronger and solid sooner.

A growth plate injury is not necessarily worse than other injuries, says Dr. Masterson. “The type of injury determines the severity and the need for surgical versus non-operative care.”

Another difference between children and adults is that their bones fracture differently, says Dr. Masterson. “We see more greenstick fractures as opposed to a clean break in the bone. The benefit of being a child with a broken bone is that it tends to heal faster; a child’s bones can accept some displacement and still heal normally.”

He also is concerned with the growing number of sports overuse injuries in young people. “In our youth, we didn’t have all of the organized sports,” he says. Children today go from baseball to football to basketball and soccer. Some organizations, such as Little League, have set rules on the number of pitches a child at each age should not exceed in a game.

And, if the child is injured, he adds, “you have to give his or her body sufficient time to heal. With kids going from sport to sport to sport, you don’t want them to return to the game too quickly.”

Dr. Masterson also treats a variety of other orthopedic injuries that occur specifically in children. For example, Osgood-Schlatter disease, the pulling of the tendons around the knee’s growth plate in adolescents, is often called growing pains. Sever’s disease, which occurs before the heel bone growth plate closes (usually between the ages of 9-11), causes pain in the heels when walking.

Another injury, known as “toddler’s fracture,” occurs most often to children under six. This spiral fracture to the leg bone is typically caused by a twisting injury to the leg. This injury most often is accidental, says Dr. Masterson, but it may also raise concern for possible child abuse.

Osteochondritis dessicans is typically seen in the knee in active 10 to 15 year olds when the cartilage and the bone loosen. If it doesn’t heal spontaneously, the cartilage can pull away from bone and cause a bone fragment to come loose. This condition typically has a better outcome when it occurs at a younger age.

These and other childhood orthopedic conditions are not necessarily worse than injuries in adults, Dr. Masterson says. The biggest concern is that the injury or condition doesn’t heal properly, causing a deformity and loss of function, he added.

As for JP, his ankle healed and the leg cast came off after a few weeks. He had to take it easy for a couple of weeks to adjust to walking and running without a cast, as his ankle and calf had weakened a little.

Dr. Masterson advised JP that in the future, if he was serious about playing sports, he should think about what he is doing on and off the field to make sure he stays in the game. With just a few weeks left to football season, JP was anxious to get back to playing center and nose guard for the Jackson Bears and decided to be more cautious in gym, on the playground and around girls.