Michael P. D'Alessandro, M.D.
Peer Review Status: Internally Peer Reviewed
Etiology/Pathophysiology:
The epiphyseal complex, including the epiphysis, physis, and
metaphysis is very susceptible to injury in children because the
ligamentous and capsular structures around a joint are 2-5 times
stronger than the most vulnerable part of the growth plate.
Approximately 10% of all fractures in kids involve the epiphyseal
complex. The prognosis and rate of complications such as limb
deformity and limb shortening depend on the fracture type with higher
Salter Harris fracture types having a worse prognosis. The fractures
are often related to athletic activity. The wrist and ankle are most
commonly affected. Seventy-five percent occur between 10 - 16 years
old.
Pathology:
Not applicable
Imaging Findings:
Salter Harris Classification of Epiphyseal Complex Fractures
Type I - fracture through the physis (widened physis)
Type II - fracture partway through the physis extending up into
metaphysis
Type III - fracture partway through the physis extending down into
the epiphysis
Type IV - fracture through the metaphysis, physis, and epiphysis --
can lead to angulation deformities when healing
Type V - crush injury to the physis
DDX:
References:
See References Chapter.
See related Provider Topics Bones, Joints and Muscles, Fractures or Injuries and Wounds.
See related Patient Topics Bones, Joints and Muscles, Fractures or Injuries and Wounds.
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