Management of a Salter Harris II distal tibia fracture

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Initial X Ray of a Salter Harris II growth plate injury of the distal tibia
Initial X ray showing gross displacement
X Ray showing unsatisfactory closed reduction - due to periosteum in the fracture line through the growth plate
After closed reduction: The medial growth plate is still widened, a sign of periosteal interposition
Operative photograph: Removing the periosteum from within the growth plate fracture line
Open reduction was required to remove the periosteum from the ruptured growth plate