Epiphyseal Fracture

Aka: Epiphyseal Fracture, Growth Plate Fracture, Salter Fracture

1. Epidemiology
   1. Epiphysis involved in 20% of pediatric Fractures
2. Images
   1. 
3. Mnemonic for Salter Fracture: SALTER
   1. Slip (Epiphysis separated from shaft)
   2. Above
   3. Low anatomic (Below)
   4. Together (Epiphysis and Metaphysis)
   5. Everything (Compressed)
   6. Round
4. Salter-Harris classification
   1. Salter I
      1. Epiphysis separate from shaft and Metaphysis
         1. through the physis
      2. Most common in newborns and young children
      3. Prognosis excellent
   2. Salter II
      1. Like Type 1, through the physis with separation of
         1. physis from metaphysis, but with a small
         2. metaphysis triangle Fracture
      2. Most common overall Epiphyseal Fracture
      3. Prognosis excellent
         1. although joint instability is possible
   3. Salter III
      1. Intraarticular Fracture through epiphysis
      2. Uncommon
      3. ORIF is often necessary
      4. Make sure reduction is adequate!
   4. Salter IV
      1. Intraarticular: Through epiphysis, plate, metaphysis
      2. Poor prognosis, lost blood supply
      3. Needs perfect reduction
   5. Salter V
      1. Crushing of physis
      2. poor prognosis
      3. Early XRay negative
      4. Rarely occurs
   6. Salter VI (Rang)
      1. Portion of growth plate sheared off
      2. Penetrating injuries
      3. Rare