Classification of Distal Radius Physeal Fractures Not Included in the Salter-Harris System
Nikolaos K Sferopoulos *
Identifiers and Pagination:Year: 2014
First Page: 219
Last Page: 224
Publisher ID: TOORTHJ-8-219
Article History:Received Date: 26/1/2014
Revision Received Date: 22/5/2014
Acceptance Date: 15/6/2014
Electronic publication date: 11 /7/2014
Collection year: 2014
open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.5/) which permits unrestrictive use, distribution, and reproduction in any medium, provided the original work is properly cited.
The most commonly used classification for pediatric physeal fractures has been proposed by Salter and Harris. Among the most suitable classification schemes are those proposed by Ogden and Peterson who added several new types of injuries. The purpose of this study was to examine the value of both schemes to classify all different types of physeal injuries of the distal radius that are not included in the Salter-Harris system and to test a new nomenclature to classify and guide treatment for the whole spectrum of these injuries.
A total of 292 children who were admitted for a physeal fracture of the distal radius that could not be classified according to the Salter-Harris system were identified from the hospital database. All radiographs were carefully examined and classified according to the existing classifications of Ogden and Peterson and a modified classification scheme. The results of the treatment were also evaluated.
Ninety-six physeal injuries could not be classified using the classification schemes of Ogden and Peterson. All injuries could be classified in five types using the new, modified nomenclature. Growth abnormalities of the distal radius were evaluated after an average follow-up time of 11 years. Growth arrest due to a physeal bar was detected only in one patient.
The proposed modified scheme is practical, incorporates all previous classification systems, allows classification of all physeal injuries of the distal radius that are not included in the Salter-Harris system and may assist comparison of treatment outcomes.