Physeal fractures represent ~35% of all skeletal injuries in children 2. 2003.Physeal fractures are also commonly called Salter-Harris fractures because the dominant and ubiquitous classification for these injuries is the Salter-Harris classification. Green: Skeletal Trauma in Children 3rd ed.“Initial Evaluation and Management of Orthopedic Injuries.” Tintinalli’s Emergency Medicine.Collaborative Hypertext of Radiology ().Prognosis is poor (premature stunting of growth is almost inevitable).Occurs most likely at the knee or ankle.Hx of significant axial loading force and significant tenderness in the area of the epiphyseal plate, should suggest the possibility of a type V injury.May be evident only retrospectively when growth disturbance first begins to appear.Occurs when the end of the bone is crushed and the growth plate compressed.Prognosis for growth is poor, unless perfect alignment is achieved and maintained during healing.Occurs most commonly at the end of the humerus near the elbow.Surgery is needed (restore joint surface/align growth plate).Fracture involving the epiphysis, metaphysis, and extending to the physis.Prognosis is good if the blood supply to the separated portion of the epiphysis is still intact and if the fracture is not displaced.Occurs only rarely (usually at the lower end of the tibia).
Fracture involving the epiphysis and extending to the physis.Usually caused by a fixed supination and external rotation force.Fracture involving part of the metaphysis and extending to the physis.Likelihood that bone will grow normally is excellent (unless there is damage to the blood supply of the growth plate).Growth plate remains attached to the epiphysis.Dx is usually clinical based on swelling and tenderness in the region of the physis.Fracture thru the physis without involvement of the bone of the epiphysis or metaphysis.V: Nothing “broken off ” compression injury of the epiphyseal plate.IV: Portion of the epiphysis + portion of the metaphysis.II: Entire epiphysis + portion of the metaphysis.Salter Harris Growth Plate Fracture Classification Type What is Broken Off Epiphyseal plate-the disk of cartilage between the metaphysis and the epiphysis of an immature long bone permitting growth in length.Metaphysis-the flared portion of the bone between the diaphysis and the epiphysis (it extends from the diaphysis to the epiphyseal line).
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