Salter–Harris fracture

A epiphysiolysis ( epiphysis Greek: επίφυσις - it Grown, arisings; lysis Greek: λύσις - detachment; Medical: resolution, detachment) is a separation of the growth plate with displacement of the epiphysis, which may occur traumatically or without external influence. The latter can be particularly Hüftkopflösung occur at the hip as a teenager.

Basics

To epiphysiolysis can only occur as long as the affected bone is not yet fully grown and still has a growth plate. Is already a part of the growth plate closed, there may be a transitional fracture.

The epiphysiolysis often occurs in connection with violations of the surrounding bone structures and in different degrees divided ( Aitken 0 -IV or Salter -Harris IV), see picture. The injury of the type IV Aitken ( Salter -Harris V) not shown indicates a complete or incomplete compression of the epiphysis, so that the growth potential is disturbed.

As with the other forms can traumatic Epiphysiolysen bring about a reduced, increased or partially altered linear growth and thus lead to later Achsfehlstellungen.

Therapy

Since the epiphysiolysis those structures may be injured, which are important for the growth of the bone, a professional therapy is particularly important in order to avoid subsequent growth failure (incomplete or odd length growth).

In the simple forms ( Aitken 0 I or Salter -Harris I and II ) is usually sufficient restraint, in the more problematic forms ( Aitken II III or Salter -Harris III IV ) is usually an additional internal fixation (eg carried out. Kirschner wires ).

Image Statement

On the top picture you can see the fresh epiphysiolysis. The distal ( distal, ie wrist near) epiphysis of the radius ( spoke) is shifted so that the radius is displaced even after palmar (hand inside surface side ). The arrow in the picture shows exactly on the level that is caused.

What may be confusing to the untrained observer here is the fact that the radius and ulna (radius and ulna ) are in these photographs one after the other and because of its relative transparency are visible on the radiograph both.

The lower picture shows the situation after the operation. Here wires ( so-called K-wires ) of each hand during the reduction (re -in- position -Mount ) were drilled through the epiphysis into the shaft of the radius. The radius is now no longer in front of palmar. The Kirschner wires remain until the epiphysis is rooted again (2-4 weeks).

Epiphysiolysis in animals

In young dogs are about 30 % of all fractures Epiphysiolysen, the most common being the upper epiphysis of the humerus and the bottom of the femur are affected. The vast majority are Salter -Harris I or II fractures. The treatment is surgical as in humans.