Tài liệu SALTER-HARRIS FRACTURE Alex Duckworth, MS4 What is a Salter-Harris fracture? Fracture through ppt

SALTER-HARRIS FRACTURE Alex Duckworth, MS4... What is a Salter-Harris fracture?ƒ Fracture through growth plate in a pediatric... Anatomy of Long Bonesƒ Epiphysis distal to the physis gro

SALTER-HARRIS

FRACTURE

Alex Duckworth, MS4

What is a Salter-Harris fracture?

ƒ Fracture through growth plate in a pediatric

Anatomy of Long Bones

ƒ Epiphysis distal to the physis (growth

Normal Pediatric Long Bone

eMedicine – Salter-Harris Fractures : Article by William

Moore, MD

immature bone remodeled

ƒ Physis closes when vascular supplies of

metaphysis and epiphysis touch

ƒ Disruption of vasculature can cause growth

deformities

ƒ Classification of fractures impacts treatment

options and prognosis/complications

Overview of Classification

Adapted from Disorders and Injuries of the Musculoskeletal System, 3rd Edition Robert

B Salter, Baltimore, Williams and Wilkins, 1999

Salter-Harris Type I (5%)

ƒ Transverse fracture through physis

ƒ Width of physis increased

ƒ Most critical part of growth plate usually remains attached to epiphysis

ƒ Normally just casting while fracture heals

ƒ Good prognosis for normal growth

Salter-Harris Type I

http://members.aol.com/PTdoctor/

salter-harris.html

http://members.fortunecity.com/rad rep/id36.htm

Salter-Harris Type II

eMedicine – Salter-Harris Fractures :

Article by William Moore, MD

www.uth.tmc.edu/radiology/test/er _primer/shoulder/sh29.html

Salter-Harris Type III (10%)

ƒ Fracture involving physis and epiphysis

ƒ Usually causes damage to reproductive

part of physis

ƒ Chronic disability because of involvement

of articular surface

ƒ Commonly requires surgery

ƒ Good prognosis for normal growth if blood supply not disrupted to epiphysis and

fracture non-displaced

Salter-Harris Type III

eMedicine – Salter-Harris Fractures :

Salter-Harris Type III

http://members.fortunecity.com/radrep/id36.htm

ƒ Surgery required to realign growth plate

ƒ Poor prognosis, high risk of growth

disturbance

Salter-Harris Type IV

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Salter-Harris Type V (<1%)

ƒ Typical history of axial load

ƒ Crush injury of growth plate, no damage to epiphysis or metaphysis

ƒ Poor prognosis, almost inevitable growth disturbance

ƒ Diagnosis difficult, often made after

premature closure of growth plate seen

Salter-Harris Type V

eMedicine – Salter-Harris Fractures :

Article by William Moore, MD

http://www.hawaii.edu/medicine/pedi atrics/pemxray/v1c18.html

Salter-Harris Type V

http://members.fortunecity.com/radrep/id36.htm

University of Hawaii John A Burns School of Medicine