What's the most likely diagnosis?

• 10 year-old with pain in ankle after fall

1. Salter-Harris I fracture
2. Salter-Harris II fracture
3. Salter-Harris III fracture
4. Salter-Harris IV fracture
5. Salter-Harris V fracture

Answer:

 

4. Salter-Harris IV fracture

 

 

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Salter-Harris Fractures

• General Considerations
• The epiphyseal pclate (physis or growth plate) is the weakest part of the bone to shearing injuries
• The Salter-Harris classification is a means of categorizing epiphyseal plate fractures and provides clues to their prognosis
• All such fractures, by definition, involve or extend through the epiphyseal plate so that all such fractures occur in children before the epiphyseal plate closes
• Salter-Harris I Fractures
• Occurs through the hypertrophic zone of the epiphyseal plate
• Only the epiphyseal plate is fractured
• Rarely produces complications
• May be difficult to diagnose unless there is visible displacement of the epiphysis on the metaphysis
• Slipped capital femoral epiphysis (SCFE) is an example of a Salter-Harris I fracture
• Salter-Harris II Fractures
• Most common Salter-Harris fracture -85%
• Involves both the epiphyseal plate and the metaphysis
• Small corner of metaphysis that is usually fractured produces the “corner sign”
• Rarely produces complications

 

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