Salter Harris fracture

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  • a fracture that involves the epiphyseal plate or growth plate of a bone
  • It is a common injury found in children
  • It occur in 15% of childhood long bone fractures
  • Type I
    • transverse fracture through the growth plate (also referred to as the “physis”)
    • 6% incidence
  • Type II – (most common type) (MCQ)
    • A fracture through the growth plate and the metaphysis, sparing the epiphysis
    • 75% incidence
    • takes approximately 2–3 weeks to heal.
  • Type III –
    • A fracture through growth plate and epiphysis, sparing the metaphysis
    • 8% incidence
  • Type IV –
    • A fracture through all three elements of the bone, the growth plate, metaphysis, and epiphysis (MCQ)
    • 10% incidence
  • Type V –
    • A compression fracture of the growth plate
    • result in a decrease in the perceived space between the epiphysis and diaphysis on x-ray
    • 1% incidence
  • The mnemonic “SALTER” (MCQ)
    • I – S = Slip
      • separated or straight across
      • Fracture of the cartilage of the physis (growth plate)
    • II – A = Above.
      • The fracture lies above the physis, or Away from the joint.
    • III – L = Lower.
      • The fracture is below the physis in the epiphysis.
    • IV – TE = Through Everything.
      • The fracture is through the metaphysis, physis, and epiphysis.
    • V – R = Rammed (crushed).
      • The physis has been crushed.
    • The higher the classification, the more severe the injury.
    • The incidence of growth disturbance is common in types III, IV and V (MCQ)

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