Salter-Harris type IV fracture

Case contributed by James Sheldon
Diagnosis certain


Fall at school.

Patient Data

Age: 11 years
Gender: Female

Intraarticular fracture involving the left 3rd metatarsal head with step depression of the dominant metatarsal head fragment of up to 2 mm. Fracture extends to involve the metaphysis consistent with a Salter Harris 4 type injury. No further fracture evident. There is mild displacement of the metatarsal head dominant fragment laterally.


Frontal radiograph with K-wire fixation.

Case Discussion

Salter-Harris type IV fractures make up approximately 10% of all growth plate fractures.

Fracture plane passes directly through the metaphysis, growth plate and epiphysis.

Poor prognosis as the proliferative and reserve zones are interrupted.

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