This patient presents with wrist pain after a trauma, suspicious for a Salter-Harris fracture. Will obtain plain films to evaluate; ortho consultation for high-grade or unstable fracture patterns, pain control, reassessment. Will likely splint with follow up in ortho clinic pending reassessment.

Pearls: SALTR
Grade 1: Straight: usually can’t see on XR
Grade 2: Above the physis (away from the joint)
Grade 3: Lower – below the physis (near the joint)
Grade 4: Through – through the physis. Unstable; will need operative repair.
Grade 5: Crush/Compression injury. Rare; difficult to pick up on initial XR. Usually from axial load force to extremity. Must consult ortho ASAP.