The epiphysis, together with the growth plate, is partially separated from the metaphysis, which is cracked. Unlike type I fractures, type II fractures typically have to be put back into place and immobilized for normal growth to continue. Because these fractures usually return to their normal shape during growth, sometimes the doctor does not have to manipulate this fracture back into position. This fracture occurs only rarely, usually at the lower end of the tibia, one of the long bones of the lower leg. It happens when a fracture runs completely through the epiphysis and separates part of the epiphysis and growth plate from the metaphysis.
Surgery is sometimes necessary to restore the joint surface to normal.
The outlook or prognosis for growth is good if the blood supply to the separated portion of the epiphysis is still intact, if the fracture is not displaced, and if a bridge of new bone has not formed at the site of the fracture. This fracture runs through the epiphysis, across the growth plate, and into the metaphysis. Surgery is needed to restore the joint surface to normal and to perfectly align the growth plate. Unless perfect alignment is achieved and maintained during healing, prognosis for growth is poor. This uncommon injury occurs when the end of the bone is crushed and the growth plate is compressed.