Wrist fracture - Salter-Harris type 2

Case contributed by Dr Camille Janet Dunn

Presentation

BIBA - Child FOOSH off BMX whilst doing a jump with obvious wrist deformity

Patient Data

Age: 12 years
Gender: Male
X-ray

Initial x-ray before reduction

Salter-Harris type 2 fracture of distal radius: The distal radial fracture appears comminuted with extension into the physis.

Transversely oriented, displaced dorsoradial angulated fractures of the left distal radial metaphysis and left distal ulnar diametaphysis.

The distal ulna fracture remains clear of the distal physis.

Congruent distal radioulnar joint. Normal carpal alignment.

X-ray

10 days post fracture

10 days post fracture:

Overlying cast in situ.  Two K-wires transfix the comminuted distal radius.  Salter-Harris II fracture in near anatomical alignment.

No metalware complication.   

Stable alignment of transverse fracture of the distal ulna metadiaphysis with radial angulation of the distal fracture fragment.

Sclerosis of fracture margins in keeping with interval healing.
 

X-ray

4 weeks post fracture

4 weeks post fracture:

Salter-Harris II fracture in near anatomical alignment. No metalware complication. Stable alignment of the distal ulna diaphysis fracture with radial and volar angulation of the distal fracture fragment.

Sclerosis of fracture margins and surrounding periosteal reaction in keeping with interval healing.

Case Discussion

This radiology series demonstrates the first two stages of normal fracture healing: inflammatory and reparative stage.  The third stage been remodelling 1.

Type 2 Salter-Harris fractures the most common type of Salter-Harris fracture. They are a transverse fracture through the growth plate and an oblique or vertical fracture through the metaphysis 2.  As with most Salter-Harris type 2 fractures, this fracture required OIF.

PlayAdd to Share

Case information

rID: 64954
Published: 5th Jan 2019
Last edited: 14th Aug 2019
Inclusion in quiz mode: Included

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.