Salter Harris I Fracture Proximal Humerus

	This 14 year old boy presented to the Emergency Department following a fall off his pushbike. On examination he was found to have a painful and swollen right shoulder. He was referred for right shoulder radiography. The AP shoulder image demonstrates a proximal humerus growth plate injury. The proximal humeral metaphysis is displaced laterally with respect to the proximal humeral epiphysis. This appearance is consistent with a Salter Harris I growth plate fracture. It is noteworthy that there appears to be a small fragment of bone on the medial aspect of the metaphysis. If this fragment of bone is sourced from the proximal humeral metaphysis, this is a SHII rather than a SHI injury.
	The lateral scapula image demonstrates posterior displacement of the proximal humeral metaphysis with respect to the proximal humeral epiphysis. The possible metaphyseal fragment is again noted anteriorly.