23r-E/2.2   Multifragmentary epiphysiolysis with metaphyseal wedge, Salter-Harris II, radius

This is a very uncommon fracture pattern. They are generally caused by high energy impact. These fractures are mainly seen in children near skeletal maturity.

The fracture is associated with local tenderness over the distal radius. Local swelling is present. Visible deformity is obvious and may be in any direction.

Check for signs of median nerve deficit.

X-ray shows a complete fracture, direction of displacement, and size as well as complexity of the metaphyseal fragments.