Salter-Harris type IV fracture

Case contributed by Hisham Alwakkaa


Autistic boy with history of injury and ankle swelling . Mechanism of the injury is unknown.

Patient Data

Age: 4 years
Gender: Male

There is a vertical lucency extends through the medial aspect of the distal tibial metaphysis and epiphysis consistent with non-displaced Salter-Harris type IV fracture. There is associated mild swelling of the soft tissues around the ankle joint with small joint effusion. There is a subtle buckle fracture of the distal fibular metaphysis.


Follow-up ankle images after 45 days show poorly visualized tibial fracture plane with anatomic alignment of the ankle joint.

Case Discussion

This is a typical case of nondisplaced Salter-Harris type IV fracture which accounts for 10% of all Salter-Harris fractures. The healing process of the fracture was unremarkable and the follow-up ankle radiographs obtained after 45 days showed poorly visualized fractures planes with stable alignment.

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