Orthopaedics

Question 1

Salter-Harris Classification

Answer 1

SALTR

1. SLIP - separated or straight across
2. ABOVE - fracture above physis, away from the joint
3. LOWER - below the physis in the epiphysis
4. THROUGH - through the metaphysis, physis and epiphysis
5. RAMMED - physis has been crushed

Question 2

What is this?

Answer 2

Salter-Harris Classification for fractures of the growth plate

Question 3

Ottawa Ankle Rules

Answer 3

1. pain over malleoli + tender at posterior edge or tip of either malleolus

AND inability to weight bear (4 steps)

OR

2. pain over midfoot + tender at navicular (medial) or base of 5th metatarsal

AND inability to weight bear (4 steps)

in all cases:

• palpate distal 6cm of tib and fib
• not applicable in under 18s
• clinical judgement if drunk, other distracting injuries, diminished sensation, ++swelling impairs palpation

come back in 5 - 7 days if no improvement