(A) Valgus and torsional stress across the knee may cause a physeal separation.
(B) In the skeletally immature athlete the medial collateral ligament remains intact and a Salter-Harris II (pictured) or III fracture occurs.
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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