SEARCH RESULTS FOR: Salter-Harris-Fracture

Salter Harris Fracture

Salter-Harris Fracture: Mechanisms, Classifications, and Findings Authors: Annmarie Lang-Hodge Reviewers: Mankirat Bhogal Michelle J. Chen Gerhard Kiefer* * MD at time of publication Longitudinal compressive force applied directly on physis Damage to hypertrophic zone, germinal matrix, & vascular supply of the physis Type V (<1%): Crushing of physeal cells & premature closure of physis No visible initial finding on imaging Incomplete calcification of cartilage to bone in the zone of provisional calcification of the physis (growth plate) The zone of provisional calcification is weak and connecting ligaments are stronger than the physis in pre-pubertal children Trauma in a pediatric patient Damage occurs to the physis (growth plate) Salter Harris Fracture Rotational, shear, +/- longitudinal forces applied to the physis Intra-articular damage Longitudinal or shear force applied to the physis Epiphysis splits from the metaphysis Type I (5%): Complete or incomplete fracture through the physis only Angular & longitudinal force exerted on the physis Type II (75%): Partial fracture through physis continuing into the metaphysis Creation of a Thurston- Holland fragment (metaphyseal fragment that is still connected to the epiphysis) Thurston-Holland fragment is visible & palpable Type III (10%): Fracture through the physis extending into the epiphysis Palpable step- off over the epiphysis only Type IV (10%): Fracture involving the epiphysis, physis, & metaphysis Swelling around joint Focal tenderness over the physis Palpable step-off over the epiphysis & metaphysis Risk of transphyseal vascularity development Recruitment of osteoprogenitor cells Bone bridge formation between the epiphysis & metaphysis Widening & separation of epiphysis from metaphysis on imaging Bone growth arrest Limb length discrepancy Asymmetric growth Post-traumatic Altered joint arthritis mechanics Growth arrest risk if the displacement is > 3mm Legend: Pathophysiology Mechanism Sign/Symptom/Lab Finding Complications Published Jan 5, 2025 on www.thecalgaryguide.com