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