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The Thurstan-Holland fragment.

M Seckler1, E C Yang

  • 1Mount Sinai Medical Center, New York City, New York.

Orthopaedic Review
|May 1, 1992
PubMed
Summary

The Thurstan-Holland fragment, a small bone piece, can be the sole X-ray sign of a healed epiphyseal separation. This finding aids in diagnosing past bone injuries in pediatric patients.

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Area of Science:

  • Orthopedic Surgery
  • Pediatric Radiology
  • Skeletal Biology

Background:

  • Epiphyseal separations are common pediatric bone injuries.
  • Radiographic diagnosis of resolved epiphyseal injuries can be challenging.
  • The Thurstan-Holland fragment is a specific radiographic finding.

Purpose of the Study:

  • To highlight the diagnostic significance of the Thurstan-Holland fragment.
  • To emphasize its role in identifying prior resolved epiphyseal separations.
  • To improve the recognition of this subtle radiographic sign.

Main Methods:

  • Review of radiographic images demonstrating Thurstan-Holland fragments.
  • Correlation with clinical history of potential epiphyseal injuries.
  • Analysis of the fragment's location and morphology.

Main Results:

  • The Thurstan-Holland fragment represents metaphyseal bone avulsed during epiphyseal separation.
  • It is often the only remaining radiographic evidence of a resolved injury.
  • Its presence confirms a history of significant physeal trauma.

Conclusions:

  • The Thurstan-Holland fragment is a crucial diagnostic marker for resolved epiphyseal separations.
  • Radiologists and orthopedic surgeons should be aware of this finding for accurate pediatric skeletal assessment.
  • Recognition aids in understanding the biomechanics of physeal injuries.

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