Salter-Harris type I fracture

Teenager with
lateral malleolus pain after a motor vehicle accident. AP radiograph of the ankle shows a tremendous amount of swelling of the lateral malleolus with the apex of the swelling centered on the distal fibular physis. There is a small bony fragment near the physis as well thought to be from an avulsion injury.The diagnosis was a Salter-Harris Type I fracture of the distal fibula.
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School ager
who tripped and fell, heard a pop, and then developed left hip pain. AP radiograph of the pelvis (upper left) shows the left femoral metaphysis to be displaced laterally from its epiphysis. This is better demonstrated on the coronal CT without contrast of the pelvis (upper right) and 3D CT of the pelvis (below)The diagnosis was slipped capital femoral epiphysis (Salter-Harris Type I fracture) of the left femur.
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Salter-Harris type I fractures are relatively uncommon injuries that occur in children. Salter-Harris fractures are injuries where a fracture of the metaphysis or epiphysis extends through the physis. Not all fractures that extend to the growth plate are Salter-Harris fractures.

Radiographic features

Salter-Harris type I fractures describe a fracture that is completely contained within the physis. There is no associated bone fragment.

In reality, the majority of fractures that involve the physis have at least a small fragment of metaphysis associated with them and are therefore type II injuries.

Radiograph
  • fracture through the physis
  • no epiphyseal or metaphyseal fracture
  • no fracture fragments
  • angulation, displacement and rotation may occur
Fractures