Physeal fractures: Part 2. Two previously unclassified types.

This article describes two physeal fractures not previously classified. The first is a fracture completely across the metaphysis with extension to the physis. There is usually no extension of the fracture along the physis, as is seen with the Salter-Harris type II fractures. It is a common fracture, occurring in 15.5% of the Olmsted County study. The second previous unclassified fracture is one in which a portion of the physis is missing. This is always an open fracture, and, thus, always requires initial surgery. It almost always develops premature physeal closure and almost always requires late reconstructive surgery.