Salter-Harris fracture Type I

Case contribution: Dr Radhiana Hassan


  • A 16 years old man
  • Motorbike skidded and fall
  • Complaint of pain at both upper limb
  • Referred to our centre for further management of fractures
Radiograph of left radius ulna in AP view


Radiograph of right wrist in AP view

Radiographic findings:

  • There are horizontal fractures of both distal radius (red arrows)
  • Displacement of fracture fragment on the left side
  • Minimal angulation of right radius fracture fragment
  • Separation and displacement of ulna physis
  • No obvious fracture at metaphysis or epiphysis is seen

Diagnosis: Salter Harris fracture type 1 of distal ulna


  • Salter-Harris fractures are fractures through a growth plate in pediatric patients.
  • These fractures are categorized according to the involvement of the physis, metaphysis, and epiphysis.–Type 1: fracture plane passes through the growth plate and not involving the bone. Good prognosis. Seen in 5-7% of cases.

    –Type II: fracture passes across the growth plate an through the metaphysis, the most common (75%) and also has good prognosis.

    –Type III: fracture plane passes across most of the growth plate and down through the epiphysis, occurs about 7-10% of cases with poorer prognosis.

    –Type IV: fracture plane passes directly through the metaphysis, growth plate an down the epiphysis, occur in about 10% of cases with poor prognosis.

    –Type V: crushing type of injury which does not displace the growth plate but damages it by direct compression. Uncommon injury seen in less than 1% of cases. It carries worst prognosis.

  • The classification of the injuries is important, because it affects patient treatment and provides clues to possible long-term complications.

    -Grade I an II : Can be treated with close reduction an casting or splinting.

    –Grade III and IV: Usually treated with open reduction an internal fixation.

Progress of patient:

  • During admission noted to have tenderness at abdomen on palpation
  • BP=148/80mmHg, PR=70 bpm and remain stable
  • CT scan shows grade II liver injury (yellow arrow)
  • Parent decided took AOR discharged and refuse further medical treatment, opted for alternative treatment
CT scan of abdomen and pelvis in axial plane
Author: radhianahassan