![]() Type V - There is a C rush injury of the growth plate, where compression is the mechanism of injury these carry the worst prognosis, however are rare to occur (Type IV - The fracture line passes through the whole growth plate, involving the metaphysis and epiphysis they often have a worse prognosis and may require surgical intervention, due to involvement of the intra-articular surface.Type III - The fracture line involves the growth plate and the bone be low (the epiphysis) they often have a worse prognosis and may require surgical intervention.the metaphysis) these are the most common type, making up 75% of all growth plate fractures Type II - The fracture line involves the growth plate and the bone above (i.e.Type I - The fracture line is straight across the growth plate with no bone involvement they often have a good prognosis (unless there is significant displacement of the epiphysis).Type I and II fractures are usually minimally displaced and good outcomes can be achieved with conservative management.Īn acceptable closed reduction of the fracture seen on post-manipulation plain film radiograph can then be managed with immobilisation in a cast or splint, and review in orthopaedic fracture clinic in 7 days post-injury.Ĭhildren with growth plate fractures may present late if more than 5 days after the injury, then manipulation should not be attempted and if not well-aligned, then operative intervention may be needed. The management of growth plate fractures can be guided by the Salter-Harris Classification, however patient- and injury-specific factors will also influence definitive management chosen Type I and II Fractures It is also important to assess for any potential safeguarding concerns, as with any paediatric injury that has occurred. Ensure a full secondary survey is completed, to identify any further injuries or suspected fractures that may have been missed. Type V – There is a C rush injury of the growth plate, where compression is the mechanism of injury these carry the worst prognosis, however are rare to occur (Type IV – The fracture line passes through the whole growth plate, involving the metaphysis and epiphysis they often have a worse prognosis and may require surgical intervention, due to involvement of the intra-articular surface.Type III – The fracture line involves the growth plate and the bone be low (the epiphysis) they often have a worse prognosis and may require surgical intervention.Type II – The fracture line involves the growth plate and the bone above (i.e.Type I – The fracture line is straight across the growth plate with no bone involvement they often have a good prognosis (unless there is significant displacement of the epiphysis).3), useful to guide appropriate management and prognosis (the acronym SALTR is useful to remember the order): Growth plate fractures are best classified using the Salter-Harris Classification (Fig. Ensure to always assess (and document) the neurovascular status Salter-Harris Classification ![]() On examination, there may be bruising or swelling around the affected site, and with visible deformity at the fracture site in severe cases. Like most fractures, they will be unable to weight bear (if affecting the lower limb). ![]() Patients with a growth plate fractures will usually present with pain at the affected site. Most growth plate fractures will occur following a fall or twist, however they can less commonly be caused by repetitive activities, such as gymnastics or running. ![]()
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