Salter-Harris classification

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The Salter-Harris classification was proposed by Salter and Harris in 1963 ¹ and at the time of writing (June 2016) remains the most widely used system for describing physeal fractures.

Classification

Conveniently the Salter-Harris types can be remembered by the mnemonic SALTR.

type I
- slipped
- 5-7%
- fracture plane passes all the way through the growth plate, not involving bone
- cannot occur if the growth plate is fused ^cit
- good prognosis
type II
- above
- ~75% (by far the most common)
- fracture passes across most of the growth plate and up through the metaphysis
- good prognosis
type III
- lower
- 7-10%
- fracture plane passes some distance along the growth plate and down through the epiphysis
- poorer prognosis as the proliferative and reserve zones are interrupted
type IV
- through or transverse or together
- intra-articular
- 10%
- fracture plane passes directly through the metaphysis, growth plate and down through the epiphysis
- poor prognosis as the proliferative and reserve zones are interrupted
type V
- ruined or rammed
- uncommon <1%
- crushing type injury does not displace the growth plate but damages it by direct compression
- worst prognosis

Others

There are a few other rare types which you should probably never include in a report as almost no one will know what you are talking about. Nonetheless, they are:

type VI: injury to the perichondral structures
type VII: isolated injury to the epiphyseal plate
type VIII: isolated injury to the metaphysis, with a potential injury related to endochondral ossification
type IX: injury to the periosteum that may interfere with membranous growth

~~-<a href="/articles/type-iv-salter-harris-fracture">type IV</a><ul>~~
+<a title="type IV" href="/articles/type-iv-salter-harris-fracture">type IV</a><ul>
~~-<a href="/articles/type-v-salter-harris-fracture">type V</a><ul>~~
+<a title="type V" href="/articles/type-v-salter-harris-fracture">type V</a><ul>
~~-type VI: injury to the perichondral structures</li>~~
+<a title="type VI" href="/articles/type-vi">type VI</a>: injury to the perichondral structures</li>
~~-type VII: isolated injury to the epiphyseal plate</li>~~
+<a title="type VII" href="/articles/type-vii">type VII</a>: isolated injury to the epiphyseal plate</li>
~~-type VIII: isolated injury to the metaphysis, with a potential injury related to <a href="/articles/endochondral-ossification">endochondral ossification</a>~~
+<a title="type VIII" href="/articles/type-viii">type VIII</a>: isolated injury to the metaphysis, with a potential injury related to <a href="/articles/endochondral-ossification">endochondral ossification</a>
~~-type IX: injury to the periosteum that may interfere with membranous growth</li>~~
+<a title="type IX" href="/articles/type-ix">type IX</a>: injury to the periosteum that may interfere with membranous growth</li>

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Salter-Harris classification

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