Table Of Contents
Physeal Injuries
Injury to the growth plates can lead to premature growth arrest or angulation deformity. Shortening occurs due to a complete arrest, while angulation occurs due to an incomplete arrest. Treatment depends on the injury (closed reduction vs ORIF vs CRPP).
Salter-Harris Classification of Physeal Injuries
| Classification | Description |
|---|---|
| Type I (5%) | Straight across. Simple transverse fracture through the physis. |
| Type II (75%) | Above. Fracture through the physis in continuity into the metaphysis. Leaves a fragment of bone (Thurston-Holland fragment). Takes approximately 2 – 3 weeks to heal. |
| Type III (10%) | Low. Fracture through the physis with continuity into the epiphysis. Associated with growth disturbance since it damages the ‘reproductive’ layers of the physis (these layers are closer to the epiphysis than the metaphysis) |
| Type IV (10%) | Through. Fracture through the physis extending into the metaphysis and epiphysis. Leaves a fragment of bone (Thurston-Holland fragment). |
| Type V (1%, uncommon) | ERasure. Crush injury that compresses the physis. Seen as a decrease in perceived space between the epiphysis and diaphysis on X-eray. May result in growth arrest as the growth plate is crushed. |
