Case 12 Answer

Well here is the lateral. Does it make a difference?

Without the lateral there are 2 possible answers:

1) Tillaux fracture - a Salter-Harris 3 (mnemonic: S-A-lower-T-R) of the lateral aspect of the lower tibial epiphysis (an avulsion fracture from the anterior tibiofibular ligament)

2) triplanar fracture - Salter-Harris 4 (mnemonic: S-A-L-through-R) of the lateral aspect of the lower tibial epiphysis (again, external rotational injury( but the fracture is in all 3 planes (axial - through the physis, sagittal - physis “down” to the articular surface, and coronal - physis “up” through the metaphysis).

Above is the lateral

Answer: this is a Tillaux fracture (only physeal, ie SH3, with NO coronal/”upward” fracture to be seen on the lateral exam)

reference:

Tillaux: https://radiopaedia.org/articles/tillaux-fracture

triplanar: https://radiopaedia.org/articles/triplane-fracture