Which Salter-Harris type is characterized by injury to the growth plate with no metaphyseal or epiphyseal fracture?

Which Salter-Harris type is characterized by injury to the growth plate with no metaphyseal or epiphyseal fracture?

• A. Type I
• B. Type II
• C. Type III
• D. Type IV

Answer: (A)

Injuries that slip through the growth plate itself, without a fracture of the nearby bone, are the hallmark of this type. The fracture line goes through the physis (the growth plate) only, so the metaphysis and the epiphysis stay intact on imaging. Because the damage is limited to the physis, the initial X-ray can be normal or may show only widening of the growth plate. The mechanism is often a shear force across the growth plate. This type typically occurs in younger children when the physes are still open and relatively vulnerable. The good news is that, if the fracture is nondisplaced and you immobilize appropriately, the prognosis is generally favorable. However, damage to the growth plate carries a risk of growth disturbances or angular deformities later on, especially if reduction is delayed or if there is significant displacement. Other Salter-Harris patterns involve the physis plus the metaphysis, or the physis plus the epiphysis, or all three structures, which is why they are distinct from this presentation.

Injuries that slip through the growth plate itself, without a fracture of the nearby bone, are the hallmark of this type. The fracture line goes through the physis (the growth plate) only, so the metaphysis and the epiphysis stay intact on imaging.

Because the damage is limited to the physis, the initial X-ray can be normal or may show only widening of the growth plate. The mechanism is often a shear force across the growth plate. This type typically occurs in younger children when the physes are still open and relatively vulnerable. The good news is that, if the fracture is nondisplaced and you immobilize appropriately, the prognosis is generally favorable. However, damage to the growth plate carries a risk of growth disturbances or angular deformities later on, especially if reduction is delayed or if there is significant displacement.

Other Salter-Harris patterns involve the physis plus the metaphysis, or the physis plus the epiphysis, or all three structures, which is why they are distinct from this presentation.