Salter Harris Fracture

What is Salter Harris Fracture?

Salter Harris Fracture is a break in a long bone. A long bone is a bone that is longer than it is wide. The break happens near the end of the bone, in the part of the bone that is still growing (growth plate). There are five types of Salter–Harris fractures:

• Type 1. This is a break through the entire growth plate.
• Type 2. This is a break through part of the growth plate that extends into the shaft of the bone.
• Type 3. This is a break through part of the growth plate and through the end of the bone.
• Type 4. This is a break through the growth plate, the bone shaft, and the end of the bone.
• Type 5. In this type of fracture, the growth plate is crushed (compressed).

Salter Harris Fracture should be treated quickly to prevent the long bone from growing abnormally.

What are the causes?

This condition may be caused by a sudden injury or by stress from overuse.

What increases the risk?

Salter Harris Fracture is more likely to develop in:

• Males.
• Teens.
• Children who participate in sports such as football, basketball, and gymnastics.
• Children who do recreational activities such as biking, skating, or skiing.

What are the symptoms of Salter Harris Fracture?

The main symptom of this condition is pain that is persistent or severe. Other symptoms include:

• Inability to move the affected area.
• Limited ability to move the finger, wrist, or ankle of the arm or leg where the injury occurred.
• A crooked appearance in the affected finger, arm, or leg.
• Swelling, warmth, and tenderness near the fracture.

How is this diagnosed?

Salter Harris Fracture may be diagnosed with a physical exam and X-rays. If the X-rays do not show a clear view of a fracture, your child may also have an MRI, CT scan, or other imaging test.

How is this treated?

Salter Harris Fracture may be treated with:

• A splint. Your child may need to wear a splint until the swelling goes down.
• A cast. After swelling has gone down, your child may need to wear a cast to keep the fractured bone from moving while it heals.
• A procedure to move the fractured bone back into position without surgery (closed reduction).
• Surgery to align and fix the bone pieces into place with metal screws, plates, or wires (open reduction and internal fixation, ORIF).

Follow these instructions at home:

Medicines

• Give over-the-counter and prescription medicines only as told by your child’s health care provider.
• Your child should not drive or use heavy machinery while taking prescription pain medicine.

If your child has a splint:

• Have your child wear the splint as told by your child’s health care provider. Remove it only as told by the health care provider.
• Loosen the splint if your child’s fingers or toes tingle, become numb, or turn cold and blue.
• Keep the splint clean.
• If the splint is not waterproof:
  • Do not let it get wet.
  • Cover it with a watertight covering when your child takes a bath or a shower.

If your child has a cast:

• Do not allow your child to stick anything inside the cast to scratch the skin. Doing that increases your child’s risk for infection.
• Check the skin around the cast every day. Tell your child’s health care provider about any concerns.
• Do not put lotion on the skin underneath the cast. You may put lotion on dry skin around the edges of the cast.
• Keep the cast clean.
• If the cast is not waterproof:
  • Do not let it get wet.
  • Cover it with a watertight covering when your child takes a bath or a shower.

Managing pain, stiffness, and swelling

• If directed, put ice on the injured area.
  • If your child has a removable splint, remove it as told by your child’s health care provider.
  • Put ice in a plastic bag.
  • Place a towel between your child’s skin and the bag.
  • Leave the ice on for 20 minutes, 2–3 times a day.
• Your child should:
  • Gently move his or her toes and fingers often to avoid stiffness and to lessen swelling.
  • Raise (elevate) the injured area above the level of his or her heart while lying down and, when possible, while sitting.

General instructions

• Do not allow your child to use the injured limb to support his or her body weight until the health care provider says that it is okay. Have your child use crutches as directed by the health care provider.
• Have your child return to his or her normal activities as told by the child’s health care provider. Ask the health care provider what activities are safe for your child.
• Do not have your child take baths, swim, or use a hot tub until the health care provider approves. Ask the health care provider if your child can take showers. Your child may only be allowed to take sponge baths.
• Keep all follow-up visits as told by your child’s health care provider. This is important.

Contact a health care provider if:

• Your child’s splint or cast gets damaged or breaks.

Get help right away if:

• Your child has severe pain.
• Your child has a burning or stinging sensation under or near the cast.
• Your child has more swelling than before the cast was put on.
• Your child’s skin or nails below the injury become numb or turn cold, blue, or gray.
• There is fluid coming from under the cast.
• Your child cannot move his or her fingers or toes below the cast.

Summary

• A break close to a bone’s end in the portion of the bone that is still growing is known as a Salter Harris fracture.
• Stress from overuse or a sudden accident could be the cause of this illness.
• Persistent or severe pain is the primary sign of Salter Harris Fracture.
• A cast, splint, or surgery are possible treatments for Salter Harris Fractures.
• Observe the guidance provided by the healthcare practitioner regarding the use of casts or splints, ice, and medications, as well as limitations on activities and bathing.