Musculoskeletal System

It grades pediatric physeal (growth-plate) fractures I–V (mnemonic SALTR: Slipped, Above, Lower, Through, Rammed/crush). Higher grades (III–V) cross the physis and carry greater risk of growth arrest and deformity.

The bone communicates with the external environment through a skin breach, creating high infection/osteomyelitis risk. Management: irrigation, early IV antibiotics, tetanus prophylaxis, and urgent operative debridement.

Distal pulses, capillary refill, sensation, and motor function — documented before and after any reduction or splinting, because vascular or nerve injury changes urgency and management.

Tenderness in the anatomic snuffbox after a fall on an outstretched hand (FOOSH). Initial X-rays are often negative; treat empirically with a thumb spica splint and repeat imaging/MRI in 1–2 weeks.

Its blood supply is retrograde, entering distally, so a proximal-pole fracture can devascularize the proximal fragment and cause avascular necrosis/nonunion.