DDX of Salter-Harris fractures

Approach to the DDX of Salter-Harris fractures:

  • A unique way that children’s bones differ from adult’s bones is that children’s ligaments are stronger than their bones which leads to Salter-Harris metaphyseal / epiphyseal fractures
  • Remember that the higher the grade of Salter-Harris fracture, the more likely the development of the serious complication of Salter-Harris fractures of premature growth plate fusion
  • Have a high index of suspicion for a bony bridge forming across growth plate during healing, which can lead to premature fusion of growth plate and limb length discrepancy
  • Do not confuse apophyseal fractures with Salter-Harris fractures