Diagnosis

21r-E/1.1 Radius, epiphysiolysis, Salter-Harris I

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The majority of fractures of the proximal radius in childhood are radial neck fractures, 21r-E and 21r-M.

Isolated epiphyseal fractures of the radius with complete separation of epiphysis (Salter-Harris I) are classified as 21r-E/1.1.

An additional code (I-III) takes into account the axial deviation and extent of displacement.

Options
1. 21r-E/1.1 I Epiphysiolysis, SH I, no angulation and no displacement
2. 21r-E/1.1 II Epiphysiolysis, SH I, angulation and displacement of up to half of the bone diameter
3. 21r-E/1.1 III Epiphysiolysis, SH I, angulation with displacement of more than half of the bone diameter

1. 21r-E/1.1 I Epiphysiolysis, SH I, no angulation and no displacement

21r-E/1.1 I

21r-E/1.1 I

Type-I fractures are undisplaced without angulation.

2. 21r-E/1.1 II Epiphysiolysis, SH I, angulation and displacement of up to half of the bone diameter

21r-E/1.1 II

21r-E/1.1 II

Type-II fractures are fractures with angulation and displacement of up to half of the bone diameter.

The annular ligament is intact but may be trapped between the fracture fragments.

The head may be impacted in the metaphysis.

3. 21r-E/1.1 III Epiphysiolysis, SH I, angulation with displacement of more than half of the bone diameter

21r-E/1.1 III

21r-E/1.1 III

Medial or dorsal displacement

Medial or dorsal displacement

Type-III fractures are angulated fractures with displacement of more than half of the bone diameter. Displacement is usually lateral.

The annular ligament is intact but may be trapped between the fracture fragments.

The head may be impacted in the metaphysis.

Medial or dorsal displacement
These fracture pattern are very rare.

The radial head may be completely displaced medially or dorsally.

These types of fractures have the highest risk of AVN because of circumferential disruption of the periosteum.

Take particular care that the surgical approach does not complete disruption of the periosteum.