A 9-year-old boy falls from a bicycle. Wrist radiograph shows a fracture through the distal radial metaphysis with extension across the physis into the epiphysis, producing a triangular metaphyseal fragment. According to the Salter-Harris classification, this fracture is:

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

Explanation

Salter-Harris type II fractures pass through the physis and exit through the metaphysis, producing the characteristic Thurston Holland triangular metaphyseal fragment. They are the commonest physeal fractures and carry a good prognosis because the germinal layer of the physis remains with the epiphysis. Type I involves the physis alone, type III passes through the physis and epiphysis into the joint, and type IV crosses metaphysis, physis, and epiphysis, carrying the highest risk of growth arrest. Recognising the metaphyseal corner fragment is what assigns this case to type II.

Reference: Grainger and Allison's Diagnostic Radiology, 7th ed.

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Written and medically reviewed by the StethoPrep medical team.