Template:Condition: Difference between revisions
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== Point tenderness on palpation at the epiphyseal plate may indicate a fracture. Other signs to look for are persistent pain or pain that affects the child’s ability to tolerate weight bearing through the limb or use of the limb. <ref name="NIAMS" />Soft tissue swelling and/or visible deformity could be another sign of a fracture.<ref name="NIAMS" /> == | == Point tenderness on palpation at the epiphyseal plate may indicate a fracture. Other signs to look for are persistent pain or pain that affects the child’s ability to tolerate weight bearing through the limb or use of the limb. <ref name="NIAMS" />Soft tissue swelling and/or visible deformity could be another sign of a fracture.<ref name="NIAMS" /> == | ||
== Diagnostic Procedures | == Diagnostic Procedures == | ||
The diagnostic process begins with obtaining a history of the patients medical status and the mechanism of injury. X-rays will then be obtained but these may be negative. The contralateral limb will be x-rayed as well for comparison. <br>Magnetic resonance imaging (MRI), computed tomography (CT) and ultrasound may also be used. <ref name="NIAMS" /><br> | |||
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== Management / Interventions<br> == | == Management / Interventions<br> == | ||
Revision as of 22:47, 18 November 2009
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Salter Harris fractures are unique to children because they involve the growth plate which is located between the shaft of a long bone and each end of the bone.
Cartilage grows from the epiphysis up toward the metaphysis and neovascularization develops from the metaphysis toward the epiphysis. Damage to the vascular supply will disrupt bone development but damage to the cartilage may not cause a problem if it is repositioned appropriately and the vasuclar supply has not been disrupted.
For purposes of this wiki I will discuss Salter-Harris fractures that are classified into 5 types.
• Type I is a fracture through the growth plate. The growth plate is completely separated from the end of the bone (metaphysis) but remains attached to the epiphysis.
• Type II extends through the metaphysis and the growth plate. There is no involvement of the epiphysis. This is the most common of the Salter-Harris fractures.
• Type III is a fracture through the growth plate and the epiphysis. This is rare and when it does occur, it is usually at the distal end of the tibia.
• Type IV extends through the epiphysis, the growth plate and the metaphysis.
• Type V is a crushing type injury that affects the growth plate.
The following links is a good visual represenatation of the structures involved in these fractures. emedicine.medscape.com/article/412956-print[edit source]
== There are Type VI-Type IX fractures also but these are rare.
==
Mechanism of Injury / Pathological Process
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Salter-Harrisfractures are often the result of sports related injuries however they have also been attributed to child abuse, genetics, injury from extreme cold, radiation and medications, neurological disorders, and metabolic diseases which all affect the growth plate according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases.[1]
Approximately 1/3rd of Salter-Harris fractures occur as the result of sports and 1/5th occur from recreational activites.
They may result from a single injury or may be caused by repetitive stresses on the upper and lower extremities.[1]
Point tenderness on palpation at the epiphyseal plate may indicate a fracture. Other signs to look for are persistent pain or pain that affects the child’s ability to tolerate weight bearing through the limb or use of the limb. [1]Soft tissue swelling and/or visible deformity could be another sign of a fracture.[1][edit source]
Diagnostic Procedures[edit source]
The diagnostic process begins with obtaining a history of the patients medical status and the mechanism of injury. X-rays will then be obtained but these may be negative. The contralateral limb will be x-rayed as well for comparison.
Magnetic resonance imaging (MRI), computed tomography (CT) and ultrasound may also be used. [1]
Management / Interventions
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add text here relating to management approaches to the condition
Differential Diagnosis
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add text here relating to the differential diagnosis of this condition
Key Evidence[edit source]
add text here relating to key evidence with regards to any of the above headings
Resources
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Case Studies[edit source]
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Recent Related Research (from Pubmed)[edit source]
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References[edit source]
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