Authors of section

Authors

Arnold Besselaar, Daniel Green, Andrew Howard

Executive Editor

James Hunter

General Editor

Fergal Monsell

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33-E/1.1 Epiphysiolysis, Salter-Harris I

Definition

Epiphyseal fractures of the distal femur with complete separation of epiphysis (Salter-Harris I) are classified as 33-E/1.1.

True Salter-Harris I fractures are rare and there is often a small metaphyseal fragment.

Epiphysiolysis (Salter-Harris I) of the distal femur

Further characteristics

Children struck from the lateral side, common in sports and pedestrian injuries, often have lateral displacement of the distal fragment and valgus angulation.

Hyperextension mechanisms produce anterior displacement of the distal fragment and apex posterior angulation.

Further evaluation

If these fractures are seen in children below walking age child abuse should be suspected.

X-ray

Lateral x-ray of the knee of a 6-year-old boy following a fall form a bicycle, with normal vascularity of the leg

X-ray of an epiphysiolysis (Salter-Harris I) of the distal femur