5th toe fracture - Salter-Harris type II

Case contributed by Dr Samir Benoudina

Presentation

Painful little toe after a soccer match.

Patient Data

Age: 12 years
Gender: Female

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.

Annotated image

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.

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