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Virtual Pediatric Hospital: Paediapaedia: Fracture, Epiphyseal Plate (Salter Harris) Paediapaedia: Musculoskeletal Diseases

Fracture, Epiphyseal Plate (Salter Harris)

Michael P. D'Alessandro, M.D.
Peer Review Status: Internally Peer Reviewed


Clinical Presentation:
Suspected fracture.

Etiology/Pathophysiology:
The epiphyseal complex, including the epiphysis, physis, and metaphysis is very susceptible to injury in children because the ligamentous and capsular structures around a joint are 2-5 times stronger than the most vulnerable part of the growth plate. Approximately 10% of all fractures in kids involve the epiphyseal complex. The prognosis and rate of complications such as limb deformity and limb shortening depend on the fracture type with higher Salter Harris fracture types having a worse prognosis. The fractures are often related to athletic activity. The wrist and ankle are most commonly affected. Seventy-five percent occur between 10 - 16 years old.

Pathology:
Not applicable

Imaging Findings:
Salter Harris Classification of Epiphyseal Complex Fractures
Type I - fracture through the physis (widened physis)
Type II - fracture partway through the physis extending up into metaphysis
Type III - fracture partway through the physis extending down into the epiphysis
Type IV - fracture through the metaphysis, physis, and epiphysis -- can lead to angulation deformities when healing
Type V - crush injury to the physis

DDX:

References:
See References Chapter.

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