(A) In a Salter-Harris type II fracture, the side where the fracture occurred through the physis has associated disruption of the periosteum (black arrow). The side of the fracture that passes through the metaphysis usually has an intact periosteum that can be used for fracture reduction (red arrow).
(B) With fracture reduction, the periosteum may become interposed within the fracture site, preventing an anatomic reduction (arrow).
Reproduced with permission from: Herman MJ, Smith BG. Fractures of the Distal Femoral Physis. In: Rockwood and Wilkins' Fractures in Children, 8th ed, Flynn JM, Skaggs DL, Waters PM (Eds), Lippincott Williams & Wilkins 2014. Copyright © 2014 Lippincott Williams & Wilkins.
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