Radiology Teaching Files > Case 6451444

Contributed by: Radiology Residency Program Faculty & Staff, Northeastern Ohio Universities College of Medicine-Canton Affiliated Hospitals, Ohio, USA.
Patient: 14 year old female
History: Patient presents to family physicain with lateral left ankle pain after injury.

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Findings: There is subtle widening of the epiphyseal plate of the distal fibula.  A small amount of soft tissue swelling is also seen laterally.
Diagnosis: Salter Harris Type I fracture of the distal fibula.
Discussion: Salter Harris Classification

I.                    Transverse fracture through physis, increased width of physis.  Usually growth is not impaired.  Patient will have point tenderness at epiphyseal plate.  Initial radiographs suggest separation of the physis, but radiographs taken 7-10 days after show adjacent sclerosis and periosteal reaction.

II.                 Fracture through physis and metaphysis, most common type.    

III.               Fracture through the physis and epiphysis, damage to the physis and extends into articular surface of the bone.  Favorable prognosis

IV.              Fracture through epiphysis, physis and metaphysis, also intraarticular.  Interferes with growth and can cause premature focal fusion of involved bone and deformity of the bone.

V.                 Compression of epiphyseal plate, typically secondary to axial load injury. Often retrospective diagnosis after premature closure of physis is observed.  Soft tissue edema at physis is usually present.

References: Moore, W. and Smith, T., Salter-Harris Fractures, .

Submitted by Emily Janitz, D.O. and Dan Bang, M.D., attending Radiologist Mercy Medical Center.
No comments posted.
Additional Details:

Case Number: 6451444Last Updated: 11-18-2007
Anatomy: Skeletal System   Pathology: Trauma
Modality: Conventional RadiographAccess Level: Readable by all users

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