Presentation
Blunt trauma in the playground. The patient was hit by a swinging swing and suffered a left wrist injury.
Patient Data
There is a fracture through the left radial physis, with the dorsal displacement of the epiphysis with overlapping. There is a dorsal displaced fracture fragment.
There is associated soft tissue swelling.
Case Discussion
An example of a Salter-Harris type II fracture of the left radius.
This is one of the most common childhood fractures. There is a fracture through the physis with dorsal displacement of the epiphysis. There is a fracture fragment projected dorsal to the left ulna and inferior to the displaced radial epiphysis on the lateral view. In the identified absence of a fracture through the metaphysis, one can easily call this a Salter-Harris type I fracture, however, these are relatively uncommon childhood injuries. A careful search and assessment for the fracture fragment will confirm a type II fracture as in this case. The zoomed and window-adjusted lateral view reveals the subtle displaced fragment likely from the left radial metaphysis confirming a type II rather than a type I fracture.
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