A 12-year-old girl injures her ankle. Radiographs show a vertical fracture line passing through the distal tibial epiphysis, crossing the physis and extending into the articular surface, with no involvement of the metaphysis. According to the Salter-Harris classification this is:

• A Type I
• B Type II
• C Type IV
• D Type III ✓

Explanation

Salter-Harris type III is an intra-articular fracture through the epiphysis and physis without metaphyseal involvement, exemplified by juvenile Tillaux fractures. Type II, the commonest pattern, passes through the physis and metaphysis and spares the joint. Type IV crosses metaphysis, physis and epiphysis together. Types III and IV disrupt the germinal layer and the joint surface, so they carry the highest risk of growth arrest and demand anatomical reduction.

Reference: Nelson Textbook of Pediatrics, 21st ed.

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Written and medically reviewed by the StethoPrep medical team.