Salter-Harris type II radial head fracture

Case contributed by Dr Arkadi Tadevosyan

Presentation

Fall onto an outstretched arm when playing a football.

Patient Data

Age: 9
Gender: Male

There is a well seen cortical step at the medial and lateral aspect of the proximal radial metaphysis. The oblique fracture line crosses radial proximal metaphysis up through the most growth plate and making a so called Thurstan Holland fragment.

Less well seen raised anterior fat pad, which is demonstrating the elbow sail sign and suggesting a joint effusion.

Joint alignment is congruent.

The bone age correlates with the patients age of 9 years.

Case Discussion

Salter-Harris type 2 fractures are:

  • "above"
  • ~75% (by far the most common)
  • fracture passes across most of the growth plate and up through the metaphysis
  • good prognosis

There is a good mnemonic for remembering elbow ossification centers, to verify bone age:

CRITOE

  • C - capitellum
  • R - radial head
  • I - internal epicondyle
  • T - trochlea
  • O - olecranon
  • E - external epicondyle

In this case, it was CRITO and E - external epicondyle is still not formed, which is normal for a 9 year old patient.

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Case information

rID: 54194
Case created: 27th Jun 2017
Last edited: 4th Jul 2017
Inclusion in quiz mode: Included

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