and Claudio Chillemi2
(1)
Sapienza University of Rome, Latina, Italy
(2)
Latina, Italy
Salter-Harris Fractures
Salter-Harris fractures involve the growth plate of long bone in pediatric patients (children between 10 and 15 years old). These fractures are classified regarding what structures are involved, the physis or metaphysis or epiphysis. Accurate classification of the injury is crucial; indeed the fracture can compromise the normal mechanism of endochondral ossification with formation of the bone bridging through the growth plate or damage the proliferation zone in the epiphysis, causing premature closure of the physis with limb shortening or abnormal growth. Classification of SH fractures is based on nine types of fractures. Types I–V are the most common. To remember the most frequent types, use the mnemonic SALTR (slipped, above, lower, through/transverse/together, ruined/rammed).
Imaging: In cases where fracture is suspected, radiography in AP and lateral view is the preferred preliminary modality, and findings will vary depending on the type of injury. However, radiographic examination may be difficult if the injury is serious and the patient is in acute pain and unable to be positioned correctly. In such circumstances, it may be beneficial to further evaluate the injury with CT scanning after the plain radiographs have been evaluated if radiographic findings are inadequate. CT shows tomographic multiplanar information and bone detail, and MRI shows marrow edema and abnormal bone bridging of the physis and may assess areas of abnormal bone trophism due to the fracture. MRI must be performed in patients with doubtful radiograms.
Segond Fracture
Segond fracture is due to avulsion fracture of the iliotibial band, fibular collateral ligament, and biceps femoris tendon and can be seen on MRI examination or anteroposterior radiographs.
Semimembranosus Tendon Avulsion Fracture
This specific type of avulsion injury to the semimembranosus tendon involves external rotation and abduction of flexed knee or abnormal varus stress, mechanisms that happen usually in athletes.
Radiography: This fracture is difficult to detect radiographically and may be seen only in lateral view as a displaced bone fragment posterosuperior from its insertion on the tibia.
MRI: In cases where this fracture is suspected, further investigation with MR imaging is warranted to investigate possible associated injuries including posterior meniscocapsular separation, medial posterior horn meniscal tear, and anterior cruciate ligament disruption.
Shiny Corner Sign
The term has the same meaning of ankylosing spondylitis seen on MR and represents the appearance of peripheral bone marrow lesions. This may be considered as an indirect sign of meniscal instability after a root tear.
Sinding-Larsen-Johansson Syndrome
Differently from OSs, this syndrome affects the proximal insertion of the patellar tendon on the patella.
Stay updated, free articles. Join our Telegram channel
Full access? Get Clinical Tree
