A school-age child has a Salter-Harris Type II fracture. Which statement is true?

• A. Growth disturbance of the long bones of the arm is likely
• B. There is a metaphyseal fragment on the compression side of fracture
• C. There is usually a compression or crushing injury to the physis
• D. This will require anatomic reduction using an open approach

Answer: (B)

Salter-Harris Type II fractures travel through the growth plate and extend into the metaphysis, sparing the epiphysis. This pattern creates a metaphyseal fragment on the metaphyseal (compression) side of the fracture, known as the Thurston-Holland fragment. That’s why the statement describing a metaphyseal fragment on the compression side is true. The physis is not crushed in this type (crushed physis is seen with Type V injuries). Growth disturbance is not a defining feature of this fracture, and most Type II fractures are treated with closed reduction and casting rather than an open, anatomic reduction.