High index of suspicion is necessary because spontaneous reduction can occur. Prognosis is excellent because epiphyseal blood supply is usually intact and growing cells of epiphyseal plate are undisturbed. Fracture extends transversely through the epiphyseal plate and then out through the metaphysis on the side opposite the fracture initiation resulting in a triangular metaphyseal fragment. Most frequent in children over 10 years of age. Usually treated with closed reduction.
Prognosis is excellent because the blood supply is almost always intact.
Intra-articular fracture that extends from the joint surface across the epiphysis to the epiphyseal plate and out to the periphery. Commonly involves the lower tibial epiphysis. Caused by an intra-articular shearing force. Often requires open reduction. Prognosis is good if the blood supply is intact and reduction is maintained.