Presentation
Fall at school.
Patient Data
Intraarticular fracture involving the left 3rd metatarsal head with step depression of the dominant metatarsal head fragment of up to 2 mm. Fracture extends to involve the metaphysis consistent with a Salter Harris 4 type injury. No further fracture evident. There is mild displacement of the metatarsal head dominant fragment laterally.
Frontal radiograph with K-wire fixation.
Case Discussion
Salter-Harris type IV fractures make up approximately 10% of all growth plate fractures.
Fracture plane passes directly through the metaphysis, growth plate and epiphysis.
Poor prognosis as the proliferative and reserve zones are interrupted.