Presentation
Fall onto an outstretched arm when playing a football.
Patient Data
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.