A distal tibia fracture in a 5-year-old with separation of the epiphysis and a small chip fracture of the metaphysis corresponds to which Salter-Harris type?

A distal tibia fracture in a 5-year-old with separation of the epiphysis and a small chip fracture of the metaphysis corresponds to which Salter-Harris type?

• A. Type I
• B. Type II
• C. Type III
• D. Type IV

Answer: (B)

Understanding how growth plate fractures are classified helps explain why this is Type II. Salter-Harris Type II fractures run through the growth plate and exit into the metaphysis, creating a small metaphyseal fragment (a chip) while the epiphysis remains part of the joint surface. In a five-year-old, the growth plate is open, and a distal tibia fracture described as separation of the epiphysis with a small metaphyseal chip fits this pattern: the fracture line crosses the physis and extends into the metaphysis, producing the chip, with the epiphysis spared from the fracture line extending into the joint. So this pattern is the metaphyseal chip fracture accompanying a physeal fracture—classic for Type II.

Understanding how growth plate fractures are classified helps explain why this is Type II. Salter-Harris Type II fractures run through the growth plate and exit into the metaphysis, creating a small metaphyseal fragment (a chip) while the epiphysis remains part of the joint surface. In a five-year-old, the growth plate is open, and a distal tibia fracture described as separation of the epiphysis with a small metaphyseal chip fits this pattern: the fracture line crosses the physis and extends into the metaphysis, producing the chip, with the epiphysis spared from the fracture line extending into the joint.

So this pattern is the metaphyseal chip fracture accompanying a physeal fracture—classic for Type II.