Research coverage
Growth hormone therapy and growth plate fractures in children
An HSS study Dr. Green co-authored, on a link parents had been asking about for years.
What it found
- The study compared 66 children treated at HSS for a proximal tibia physeal avulsion fracture — a break through the growth plate at the top of the shinbone — with 66 children who broke the same bone through its midshaft, away from the growth plate.
- Both groups averaged 13 years of age, with similar body mass and the same proportion of boys.
- Seven children in the growth plate group were taking human growth hormone. None in the comparison group were.
- The odds of being on growth hormone therapy were 15 times higher among the children with a growth plate fracture.
- Most of the children taking it, 86%, were taking it to increase height rather than for an underlying medical condition.
Published 21 December in the Journal of Bone and Joint Surgery; patients treated at HSS between February 2016 and May 2023.
In Dr. Green’s own words
At HSS, a big part of what our pediatric orthopedic service does is treat children with significant fractures and orthopedic injuries,
Parents frequently ask our pediatric orthopedic surgeons if human growth hormone caused their children’s fractures. Given the volume of patients we treat, we were able to investigate the relationship between tibia growth plate fractures and growth hormone therapy in pediatric patients.
We hope families deciding whether their children should start or continue growth hormone therapy consider our new evidence as they carefully weigh the pros and cons of therapy in consultation with their pediatric endocrinologists,
Further research is required to tease out whether limiting specific high-impact sports will mitigate the risk of tibia growth plate fractures in active children and adolescents.
HSS Newsroom · 4 January 2024. Dr. Green is a co-author of the study. The senior author is Peter D. Fabricant, MD, MPH, also a pediatric orthopedic surgeon at HSS. Read the original
The research behind it
His 2 papers on growth plate injury, indexed on PubMed under his Hospital for Special Surgery affiliation. Each opens on PubMed.
- No Association Between Growth Hormone Therapy and Upper Extremity Physeal Tension Injuries: A Matched Case-control Study Clinical orthopaedics and related research · 2025 Mar 1 · Dr. Green is author 6 of 7
- Strong Association Between Growth Hormone Therapy and Proximal Tibial Physeal Avulsion Fractures in Children and Adolescents: A Case-Control Study The Journal of bone and joint surgery. American volume · 2024 Feb 7 · Dr. Green is author 4 of 5