Ankle Injury in Paediatrics

Whether obtaining an X-ray or not, if there is tenderness over region associated with a growth plate, do not forget the Salter Harris I ankle injury may be present.  In this case, casting or using velcro type stirrup splint and ensuring Orthopaedic follow-up is warranted.

Salter-Harris Fracture (remember the mnemonic SALTR)

  1. Slipped (i.e., through growth plate and not involving bone) / Type I
  2. Above growth plate (i.e., through metaphysis) / Type II (most common)
  3. Lower growth plate (i.e., through epiphysis) / Type III
  4. Through (i.e., through metaphysis growth plate and epiphysis) / Type IV
  5. Rammed (i.e., Crush injury) / Type V (worst prognosis)