Tài liệu SALTER-HARRIS FRACTURE Alex Duckworth, MS4 What is a Salter-Harris fracture? Fracture through ppt

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SALTER-HARRIS FRACTURE

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What is a Salter-Harris fracture?

ƒ Fracture through growth plate in a pediatric patient

ƒ 35 % of skeletal injuries in patients aged 10-15 involve growth plate

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Anatomy of Long Bones

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Normal Pediatric Long Bone

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Bone Growth

ƒ Cartilage growth from epiphysis towards metaphysis

ƒ Neovascularizationand primary bone formation occurs from metaphysistowards epiphysis,

immature bone remodeled

ƒ Physiscloses when vascular supplies of metaphysisand epiphysis touch

ƒ Disruption of vasculature can cause growth deformities

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Overview of Classification

Adapted from Disorders and Injuries of the Musculoskeletal System, 3rd Edition Robert

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Salter-Harris Type I (5%)

ƒ Transverse fracture through physis

ƒ Width of physis increased

ƒ Most critical part of growth plate usually remains attached to epiphysis

ƒ Normally just casting while fracture heals

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Salter-Harris Type II (75%)ƒ Most commonƒ Fracture through physis as well as metaphysisƒ No epiphyseal involvement

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Salter-Harris Type II

eMedicine – Salter-Harris Fractures : Article by William Moore, MD

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Salter-Harris Type III (10%)

ƒ Fracture involving physis and epiphysis

ƒ Usually causes damage to reproductive part of physis

ƒ Chronic disability because of involvement of articular surface

ƒ Commonly requires surgery

ƒ Good prognosis for normal growth if blood supply not disrupted to epiphysis and

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Salter-Harris Type III

eMedicine – Salter-Harris Fractures :

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Salter-Harris Type III

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Salter-Harris Type IV (10%)ƒ Fracture through epiphysis, physis, and metaphysisƒ Also chronic disability because of articularsurface involvement

ƒ Damage to growing cartilage can cause premature fusion of bone

ƒ Surgery required to realign growth plate

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Salter-Harris Type IV

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Salter-Harris Type V (<1%)

ƒ Rare

ƒ Typical history of axial load

ƒ Crush injury of growth plate, no damage to epiphysis or metaphysis

ƒ Poor prognosis, almost inevitable growth disturbance

ƒ Diagnosis difficult, often made after

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Salter-Harris Type V

eMedicine – Salter-Harris Fractures : Article by William Moore, MD

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Salter-Harris Type V

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Sourcesƒhttp://www.hawaii.edu/medicine/pediatrics/pemxray/v1c18.htmlRadiology Cases in Pediatric Emergency Medicine Volume 1, Case 18 Loren G Yamamoto, MD, MPH Stanley M.K Chung, MD AlsonS Inaba, MD

KapiolaniMedical Center For Women And Children