Physeal injuries in children

The Primary Physis

“…It is composed of multiple layers that have been further subdivided into a variably reported number of zones. [3][4][5] For the purposes of this review, we describe four zones. The resting zone contains the germinal layer and is immediately adjacent to the epiphysis.…”

“…1,3,5,7-10 There is typically no displacement unless there is also disruption of the periosteum. 5,11 These fractures are relatively uncommon, with a relative incidence of 8.5%. 7,12 These fractures usually occur in children < 5 years of age due to the wide nature of the growth plate.…”

Childhood trauma: Methods for the identification of physeal fractures in nonadult skeletal remains

“…The most widely used classification for physeal fractures was developed by Salter and Harris in 1963. Type I Salter‐Harris fractures, most common in the distal fibula, describe the separation of the epiphysis from the metaphysis along with the germinal layer of the growth plate (Eastwood and de Geldere ; Fig. a).…”

“…While a type II Salter‐Harris fracture, often seen in hand phalanges and distal radius (Peterson et al, ; Cannata et al, ), refers to the separation of the epiphysis together with a triangular bone fragment of the metaphysis, which remains attached to the periosteum. Type II is the most common Salter‐Harris fracture (Peterson et al, ; Eastwood and de Geldere, ).…”

“…d). In case of a type IV Salter‐Harris fracture, the fracture line crosses the metaphysis, physis, and epiphysis in an oblique line, which leads to the separation of a large triangular fragment (Ogden, ; Eastwood and de Geldere, ; Fig. e).…”