![]() The management of growth plate fractures can be guided by the Salter-Harris Classification, however patient- and injury-specific factors will also influence definitive management chosen Type I and II Fractures It is also important to assess for any potential safeguarding concerns, as with any paediatric injury that has occurred. Ensure a full secondary survey is completed, to identify any further injuries or suspected fractures that may have been missed. Type V – There is a C rush injury of the growth plate, where compression is the mechanism of injury these carry the worst prognosis, however are rare to occur (Type IV – The fracture line passes through the whole growth plate, involving the metaphysis and epiphysis they often have a worse prognosis and may require surgical intervention, due to involvement of the intra-articular surface.Type III – The fracture line involves the growth plate and the bone be low (the epiphysis) they often have a worse prognosis and may require surgical intervention.the metaphysis) these are the most common type, making up 75% of all growth plate fractures Type II – The fracture line involves the growth plate and the bone above (i.e.Type I – The fracture line is straight across the growth plate with no bone involvement they often have a good prognosis (unless there is significant displacement of the epiphysis).3), useful to guide appropriate management and prognosis (the acronym SALTR is useful to remember the order): Growth plate fractures are best classified using the Salter-Harris Classification (Fig. Ensure to always assess (and document) the neurovascular status Salter-Harris Classification On examination, there may be bruising or swelling around the affected site, and with visible deformity at the fracture site in severe cases. ![]() Like most fractures, they will be unable to weight bear (if affecting the lower limb). Patients with a growth plate fractures will usually present with pain at the affected site. ![]() There are a few other rare types which you should probably never include in a report as almost no one will know what you are talking about.Most growth plate fractures will occur following a fall or twist, however they can less commonly be caused by repetitive activities, such as gymnastics or running. crushing type injury does not displace the growth plate but damages it by direct compression.poor prognosis as the proliferative and reserve zones are interrupted.fracture plane passes directly through the metaphysis, growth plate and down through the epiphysis.poorer prognosis as the proliferative and reserve zones are interrupted.fracture plane passes some distance along with the growth plate and down through the epiphysis.fracture passes across most of the growth plate and up through the metaphysis.cannot occur if the growth plate is fused.fracture plane passes all the way through the growth plate, not involving bone.ClassificationĬonveniently the Salter-Harris types can be remembered by the mnemonic SALTR. The Salter-Harris classification was proposed by Salter and Harris in 1963 and at the time of writing (June 2016) remains the most widely used system for describing physeal fractures.
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