Authors of section

Authors

Daniel Green, Philip Henman, Mamoun Kremli

Executive Editor

James Hunter

General Editor

Fergal Monsell

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43t-E/1.1   Epiphysiolysis (Salter-Harris I) of the distal tibia

Definition

Salter-Harris I fractures are physeal injuries without epiphyseal or metaphyseal extension.

In the distal tibia, these fractures are classified as 43t-E/1.1.

If there is a small metaphyseal fragment, the fracture is classified as Salter-Harris II.

An associated fibular fracture may have a different configuration and is classified separately.

Salter-Harris I fracture of the pediatric distal tibia

Further characteristics

These fractures are more common before the physis starts to close and occur in older children and young adolescents.

Associated fibular fractures are common when the tibial fracture is displaced.

Imaging

An undisplaced Salter-Harris fracture may not be visible on plain x-rays.

CT or MRI may be necessary to diagnose this fracture.

X-rays showing a Salter-Harris I tibial fracture with an associated metaphyseal fracture of the fibula in a 13-year-old patient

X-rays showing a Salter-Harris I distal tibial fracture with an associated metaphyseal fracture of the distal fibula in a 13-year-old patient
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