Image Based Question-71985

Correct Answer » D Explanation

Ans:D. Salter 1 Fracture.

Image shows:Salter 1 Fracture of the Proximal Humeral Epiphysis. Frontal radiograph of the shoulder in external rotation demonstrates slip of the proximal humeral epiphysis medially and inferiorly (black arrow) due to a fracture through the epiphyseal plate that causes widening of the plate (white arrow).

SALTER HARRIS FRACTURES

• The epiphyseal plate (physis or growth plate) is the weakest part of the bone to shearing injuries

• The Salter-Harris classification is a means of categorizing epiphyseal plate fractures and provides clues to their prognosis

• All such these fractures, by definition, involve or extend through the epiphyseal plate so that all such fractures occur in children before the epiphyseal plate closes.

Salter-Harris I Fractures

• Occurs through the hypertrophic zone of the epiphyseal plate

• Only the epiphyseal plate is fractured

• Rarely produces complications

• May be difficult to diagnose unless there is visible displacement of the epiphysis on the metaphysis

• Slipped capital femoral epiphysis (SCFE) is an example of a Salter-Harris I fracture

Salter-Harris II Fractures

• Most common Salter-Harris fracture -85%

• Involves both the epiphyseal plate and the metaphysis

• Small corner of metaphysis that is usually fractured produces the “corner sign”

• Rarely produces complications

Salter-Harris III Fractures

• Involves the epiphyseal plate and the epiphysis itself

• Since the epiphysis is involved, damage to the articular cartilage can occur

• Growth disturbance is uncommon

• A Tillaux fracture of the ankle is a Salter-Harris III fracture

Salter-Harris IV Fractures

• Involves the epiphyseal plate, metaphysis and epiphysis

• Since it, too, involves the epiphysis, the articular cartilage can be damaged

• Since these fractures involve the growing layer of cartilage, growth disturbance can result

Salter-Harris V Fractures

• Compression or crushing injury of epiphyseal plate

• Initial diagnosis may be difficult and not made until complication of growth disturbance at epiphyseal plate occurs resulting in angular deformities

• Associated with growth disturbance

• These injuries have the worst prognosis of the Salter-Harris fractures