A 10-year-old boy falls on an outstretched hand. Radiograph of the distal radius shows a fracture through the physis that extends into the metaphysis, producing a triangular metaphyseal fragment attached to the epiphysis. The growth plate is not otherwise disrupted. What is the Salter-Harris type?
- A Type I
- B Type III
- C Type II ✓
- D Type IV
Correct answer: C. Type II
Explanation
A physeal fracture that passes through the hypertrophic zone of the physis and exits through the metaphysis, leaving the triangular Thurstan Holland fragment, is Salter-Harris type II. It is the commonest physeal injury and carries a good prognosis because the germinal layer remains with the epiphysis. Type III crosses the physis and enters the joint through the epiphysis, while type IV crosses both metaphysis and epiphysis.
Reference: Tachdjian's Pediatric Orthopaedics, 5th ed.
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