Presentation
Twisting injury of the 5th finger
Patient Data
Widening and haziness of the physeal plate of the proximal phalanx of the 5th finger with associated periosteal reaction. There is a tiny accompanying fracture through the lateral metaphysis making it a Salter-harris type II.
Zoomed images show the heterogeneous appearance of the physeal plate with adjacent periosteal reaction. A tiny fracture through the lateral metaphysis can be noted making it a Salter-harris type II fracture.
Case Discussion
This case shows a picture of Salter-harris type II, where, the physeal plate is the site of injury with intact epiphysis and a tiny accompanying fracture through the lateral metaphysis. A careful search for the metaphyseal involvement is important, especially since true Salter-Harris I fractures have a much lower incidence than type II.
Physeal injuries can be subtle and easily missed and can be challenging to diagnosis at the initial presentation. It affects the growth plate and may cause premature closure resulting in shortening.