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Salter-Harris Fractures or Physeal Fractures

Homepage: EMNote.org Salter-Harris Fractures or Physeal Fractures: What is a physeal fracture? A physeal fracture, also known as a growth plate fracture, is a type of bone fracture that occurs at the cartilaginous growth plate in pediatric bones. These fractures are unique to children and adolescents due to the presence of growth plates, which allow bones to grow in length. Physeal fractures can disrupt normal bone growth and should be carefully diagnosed and treated to prevent long-term complications. During infancy, the epiphysis consists mainly of cartilage, serving as a shock-absorbing structure. As the child matures and bone ossification progresses, greater forces are transmitted through the bone, increasing the risk of fractures. This lecture helps clinicians to prevent common mistakes, such as misdiagnosing physeal fractures as a "sprain" and failing to schedule orthopedic follow-up. Salter-Harris classification. Take Home Message. Palpable tenderness at the growth plate level should be managed as a fracture, even if X-ray results are negative. Salter-Harris type 1 and most type 2 fractures are treated with closed reduction and cast or splint immobilization. Slipped Capital Femoral Epiphysis is a severe form of type 1 fracture which requires immediate orthopedics consultation and surgical intervention. Any growth plate fracture displaying displacement should prompt consultation with a pediatric orthopedic specialist. Salter-Harris type 3 and 4 fractures typically affect the joint surface, necessitating the need for open reduction and internal fixation. A Salter-Harris type 5 fracture is often diagnosed retrospectively, after the occurrence of growth arrest.

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