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Wheeless' Textbook of Orthopaedics

Early MR imaging of lower-extremity physeal fracture-separations: a


preliminary report. Smith BG. Rand F. Jaramillo D. Shapiro F. Journal of Pediatric Orthopedics. 14(4):526-33, 1994 Jul-Aug. Magnetic resonance imaging (MRI) was used to evaluate physeal fracture-separations in children soon after at-risk lower-extremity * fractures. MRI scans taken during the "acute" period (within 10 days of fracture) resulted in a change in three of four of the Salter-Harris classifications from the injury radiographs. Twelve children had MRI scans performed in the "early" period (3-17 weeks following fracture). Physeal narrowing or tethering and the absence of Harris arrest lines were found Á in those patients who subsequently required late surgical intervention. Acute MRI provides the most accurate evaluation of the physeal fracture anatomy. Early MRI can demonstrate transphyseal bridging or altered arrest lines in physeal fracture before they become manifest on radiographs. *



Original Text by Clifford R. Wheeless, III, MD.