Presentation
Painful little toe after a soccer match.
Patient Data
Fracture through the epiphyseal growth plate of the 5th toe proximal phalanx with a small extension through the metaphysis, creating a Thurstan Holland fragment.
These findings are consistent with a Salter Haris type II fracture.
Arrow points to a small triangle of metaphyseal bone which has followed the epiphysis = Salter Haris type II fracture.
Diagram courtesy of Dr Matt Skalski, Radiopaedia.org, rID: 27144
Case Discussion
Salter-Harris classification is used to classify pediatric fractures involving the growth plate. Type II is the most common (85%). The fracture involves both the epiphyseal plate and the metaphysis. It has a good prognosis.
The metaphyseal fragment created between the physis and the fracture line is known as the Thurstan Holland fragment/sign.