- Fracture of the joint’s rim that leads to instability. Generally require surgery.
- Appearance is similar to Colle or Smith fracture, but has intra-articular involvement.
- Can cause either volar or dorsal displacement.
- Length: <5mm of shortening
- Volar/Palmar Tilt: <5° dorsal angulation or within 20° of the other wrist
- Step off: <2mm
- Radial Inclination: <5° change
Normal wrist anatomy:
- 11° of volar tilt
- 23° of radial inclination
- 13mm radial height
- Salter-Harris II: Up to 15° of angulation and 1 cm of shortening will generally remodel. Remodeling has been estimated to be 10° of angulation per year of remaining growth.
Pediatric patients can be placed in a bivalved cast (long arm or short arm) if expertise is available.
Apply longitudinal traction and then "recreate" the injury by accentuating the deformity before applying dorsal or volar pressure to reduce the fracture.