From the Guidelines
Management of Salter-Harris type 1 fractures should prioritize immobilization with a cast or splint for 3-4 weeks, followed by gradual return to activities, as this approach minimizes the risk of complications and promotes optimal healing, as implied by general principles of fracture management 1. When managing Salter-Harris type 1 fractures, it is essential to consider the principles of fracture care that apply to all types of fractures, including those described in the context of heel pain, which may involve similar considerations for immobilization and pain management 1.
- Initial treatment includes pain management with acetaminophen or ibuprofen for 3-5 days as needed, along with elevation and ice application to reduce swelling.
- Close follow-up is crucial, with radiographs at 1-2 weeks to ensure proper alignment and at 3-4 weeks before cast removal.
- Growth plate monitoring should continue for 6-12 months to detect potential growth disturbances.
- Patients and parents should be educated about warning signs requiring immediate attention, including increasing pain, numbness, color changes, or excessive swelling. Given the nature of Salter-Harris type 1 fractures, which occur through the growth plate without extending into the metaphysis or epiphysis, the primary goal is to ensure proper healing while minimizing the risk of growth disturbances, which is generally achievable with appropriate immobilization and follow-up care, as suggested by the principles outlined in the management of heel pain 1.
From the Research
Management of Salter Harris 1 Fractures
- The Salter-Harris classification of growth plate injuries aids in estimating both the prognosis and the potential for growth disturbance 2.
- Salter-Harris type I fractures are characterized by a fracture through the growth plate, and most such fractures heal without permanent deformity 2.
- For Salter-Harris I fractures of the distal fibula, emergency physicians treat 48.3% of cases with a removable ankle support 3.
- Removable immobilization devices are at least as good as circumferential casts for the management of common specific types of pediatric wrist and ankle fractures, including Salter-Harris I fractures 3.
- The management of Salter-Harris fractures may involve different strategies, including immobilization, reduction, and fixation, depending on the type and severity of the fracture 4, 5.
- Therapeutic alliance concepts and techniques can be incorporated into the rehabilitative management of patients with Salter-Harris fractures to facilitate a successful return to activity 6.