Imaging rounds #97. Salter II fracture of the proximal tibia

Proximal tibial physeal injury is extremely rare. It occurs most often in adolescents and is the result of a significant abduction force applied to the lower leg with the foot firmly fixed. Management of this injury follows the same principles as other Salter-Harris epiphyseal plate fractures. Prognosis is generally good, although there is a somewhat higher than anticipated incidence of angulatory and longitudinal deformities of Type I and Type II fractures, much as has been observed in distal femoral physeal fractures. This is probably due to direct injury to the germinal layer of the growth plate with subsequent partial physeal closure.