Tài liệu SALTER-HARRIS FRACTURE Alex Duckworth, MS4 What is a Salter-Harris fracture? Fracture through ppt

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SALTERSALTER--HARRIS HARRIS FRACTUREFRACTUREAlex Duckworth, MS4Alex Duckworth, MS4What is a SalterWhat is a Salter--Harris fracture?Harris fracture?Fracture through growth plate in a pediatric Fracture through growth plate in a pediatric patientpatient35 % of skeletal injuries in patients aged 1035 % of skeletal injuries in patients aged 10--15 15 involve growth plateinvolve growth plateOften due to trauma, usually sportsOften due to trauma, usually sports--related or related or fallfallComplain of point tenderness around fracture Complain of point tenderness around fracture sitesiteSoftSoft--tissue swelling on physical examtissue swelling on physical examAnatomy of Long BonesAnatomy of Long BonesEpiphysis distal to the Epiphysis distal to the physisphysis(growth (growth plate)plate)MetaphysisMetaphysison opposite side of on opposite side of physisphysisfrom epiphysisfrom epiphysisDiaphysisDiaphysisis long shaft beyond is long shaft beyond metaphysismetaphysisNormal Pediatric Long BoneNormal Pediatric Long BoneeMedicine – Salter-Harris Fractures : Article by William Moore, MDBone GrowthBone GrowthCartilage growth from epiphysis towards Cartilage growth from epiphysis towards metaphysismetaphysisNeovascularizationNeovascularizationand primary bone formation and primary bone formation occurs from occurs from metaphysismetaphysistowards epiphysis, towards epiphysis, immature bone remodeledimmature bone remodeledPhysisPhysiscloses when vascular supplies of closes when vascular supplies of metaphysismetaphysisand epiphysis touchand epiphysis touchDisruption of vasculature can cause growth Disruption of vasculature can cause growth deformitiesdeformitiesClassification of fractures impacts treatment Classification of fractures impacts treatment options and prognosis/complicationsoptions and prognosis/complicationsOverview of ClassificationOverview of ClassificationAdapted from Disorders and Injuries of the Musculoskeletal System, 3rd Edition. Robert B. Salter, Baltimore, Williams and Wilkins, 1999. SalterSalter--Harris Type I (5%)Harris Type I (5%)Transverse fracture through Transverse fracture through physisphysisWidth of Width of physisphysisincreasedincreasedMost critical part of growth plate usually Most critical part of growth plate usually remains attached to epiphysisremains attached to epiphysisNormally just casting while fracture healsNormally just casting while fracture healsGood prognosis for normal growthGood prognosis for normal growthSalterSalter--Harris Type IHarris Type IeMedicine – Salter-Harris Fractures : Article by William Moore, MDhttp://radiology.creighton.edu/ /case6/index.htmSalterSalter--Harris Type IHarris Type Ihttp://members.aol.com/PTdoctor/salter-harris.htmlhttp://members.fortunecity.com/radrep/id36.htmSalterSalter--Harris Type II (75%)Harris Type II (75%)Most commonMost commonFracture through Fracture through physisphysisas well as as well as metaphysismetaphysisNo No epiphysealepiphysealinvolvementinvolvementUsually requires manipulation of fracture Usually requires manipulation of fracture back into position and immobilization for back into position and immobilization for normal growthnormal growth[...].. .Salter-Harris Type II eMedicine – Salter-Harris Fractures : Article by William Moore, MD www.mevis.de/~hhj/TraumaRad/TraumaRa dHiRes.htm Salter-Harris Type II eMedicine – Salter-Harris Fractures : Article by William Moore, MD www.uth.tmc.edu/radiology/test/er _primer/shoulder/sh29.html Salter-Harris Type III (10%) Fracture involving physis and epiphysis Usually causes damage to reproductive part... http://members.fortunecity.com/radrep/id36.htm Salter-Harris Type IV (10%) Fracture through epiphysis, physis, and metaphysis Also chronic disability because of articular surface involvement Damage to growing cartilage can cause premature fusion of bone Surgery required to realign growth plate Poor prognosis, high risk of growth disturbance Salter-Harris Type IV eMedicine – Salter-Harris Fractures : Article by William Moore,... http://xray.20m.com/photo4.html Salter-Harris Type IV http://members.fortunecity.com/radrep/id36.htm Salter-Harris Type V ( . SALTERSALTER--HARRIS HARRIS FRACTURE FRACTURE Alex Duckworth, MS4 Alex Duckworth, MS4 What is a Salter What is a Salter--Harris fracture? Harris. (10%)Harris Type IV (10%) Fracture through epiphysis, Fracture through epiphysis, physisphysis, and , and metaphysismetaphysisAlso chronic disability
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