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.
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.
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