Salter-Harris classification

Changed by Mohamed Saber, 25 Oct 2020

Updates to Article Attributes

Body was changed:

Show markup changes

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 with 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 title="Salter-Harris type IV fracture" href="/articles/salter-harris-type-iv-fracture">type IV</a><ul>~~
+<a href="/articles/salter-harris-type-iv-fracture">type IV</a><ul>
~~-<a title="Salter-Harris type V fracture" href="/articles/salter-harris-type-v-fracture">type V</a><ul>~~
+<a href="/articles/salter-harris-type-v-fracture">type V</a><ul>

Images Changes:

Image 22 X-ray (Frontal) ( create )

ADVERTISEMENT: Supporters see fewer/no ads

{"current_user":null,"inclusions":[{"imageId":57220096,"studyId":117726,"caseSlug":"salter-harris-classification-1","caption":"Figure 1: Salter-Harris classification","thumbnail":"https://prod-images-static.radiopaedia.org/images/57220096/0._big_gallery.jpeg","isStack":false,"diagnosticCertainty":"not_applicable"},{"imageId":5668583,"studyId":27315,"caseSlug":"salter-harris-illustrations-1","caption":"Figure 3: type I","thumbnail":"https://prod-images-static.radiopaedia.org/images/5668583/3f2932607def8c2f2ca3c17b1d8152_big_gallery.jpg","isStack":false,"diagnosticCertainty":"not_applicable"},{"imageId":5668578,"studyId":27315,"caseSlug":"salter-harris-illustrations-1","caption":"Figure 2: normal","thumbnail":"https://prod-images-static.radiopaedia.org/images/5668578/60116d291d48e9ddcdf0a5990c951a_big_gallery.jpg","isStack":false,"diagnosticCertainty":"not_applicable"},{"imageId":5668588,"studyId":27315,"caseSlug":"salter-harris-illustrations-1","caption":"Figure 4: type II","thumbnail":"https://prod-images-static.radiopaedia.org/images/5668588/b429a76f6495ba19d75b93cf2a2395_big_gallery.jpg","isStack":false,"diagnosticCertainty":"not_applicable"},{"imageId":3068591,"studyId":22269,"caseSlug":"salter-harris-type-i-shoulder-injury","caption":"Case 1: type I","thumbnail":"https://prod-images-static.radiopaedia.org/images/3068591/4352f6f9e9a30eb6cc6f18158257e3_big_gallery.jpg","isStack":false,"diagnosticCertainty":"confirmed_substantiated"},{"imageId":5668594,"studyId":27315,"caseSlug":"salter-harris-illustrations-1","caption":"Figure 5: type III","thumbnail":"https://prod-images-static.radiopaedia.org/images/5668594/0737810408ee33d10d2696051725a2_big_gallery.jpg","isStack":false,"diagnosticCertainty":"not_applicable"},{"imageId":5753519,"studyId":27536,"caseSlug":"salter-harris-type-ii-wrist-fracture-1","caption":"Case 2: type II","thumbnail":"https://prod-images-static.radiopaedia.org/images/5753519/dba173c64883b429b0257d0863b95f_big_gallery.jpeg","isStack":false,"diagnosticCertainty":"confirmed_substantiated"},{"imageId":11647298,"studyId":36373,"caseSlug":"salter-harris-type-iii-fracture-of-distal-tibia-with-comminuted-talus-fracture","caption":"Case 3: type III (with concurrent talar fracture)","thumbnail":"https://prod-images-static.radiopaedia.org/images/11647298/e52db83c25a8bc7adcee131716ef82_big_gallery.jpg","isStack":true,"diagnosticCertainty":"confirmed_substantiated"},{"imageId":5668598,"studyId":27315,"caseSlug":"salter-harris-illustrations-1","caption":"Figure 6: type IV","thumbnail":"https://prod-images-static.radiopaedia.org/images/5668598/6893b24caf23a7aefb6454edf9350b_big_gallery.jpg","isStack":false,"diagnosticCertainty":"not_applicable"},{"imageId":4713040,"studyId":25171,"caseSlug":"salter-harris-type-iv-fracture-4","caption":"Case 4: type IV","thumbnail":"https://prod-images-static.radiopaedia.org/images/4713040/924e8f0ee1fc6168a2ad92a47f8847103971b5b9210942c6ba89021efc878c39_big_gallery.jpeg","isStack":false,"diagnosticCertainty":"confirmed_substantiated"},{"imageId":5668607,"studyId":27315,"caseSlug":"salter-harris-illustrations-1","caption":"Figure 7: type V","thumbnail":"https://prod-images-static.radiopaedia.org/images/5668607/63a49d73d2551ee095e0e089a9ebb0_big_gallery.jpg","isStack":false,"diagnosticCertainty":"not_applicable"},{"imageId":7911041,"studyId":31019,"caseSlug":"salter-harris-type-1-fracture-finger","caption":"Case 5: type I","thumbnail":"https://prod-images-static.radiopaedia.org/images/7911041/85c1dc8fa1589991815b0b091339fa_big_gallery.jpeg","isStack":false,"diagnosticCertainty":"confirmed_substantiated"},{"imageId":51705098,"studyId":82466,"caseSlug":"salter-harris-fracture-of-apophysis","caption":"Case 6: type II through apophysis","thumbnail":"https://prod-images-static.radiopaedia.org/images/51705098/b45dd5c997da6cda41c682bc263369_big_gallery.jpeg","isStack":false,"diagnosticCertainty":"confirmed_substantiated"},{"imageId":10679891,"studyId":35033,"caseSlug":"salter-harris-type-i-fibula-1","caption":"Case 7: type I ","thumbnail":"https://prod-images-static.radiopaedia.org/images/10679891/fc7d50346e7fab67d91986a9694131_big_gallery.jpg","isStack":false,"diagnosticCertainty":"confirmed_substantiated"},{"imageId":19781568,"studyId":46438,"caseSlug":"salter-harris-type-i-growth-plate-injury-2","caption":"Case 8: type I","thumbnail":"https://prod-images-static.radiopaedia.org/images/19781568/03fcacd8f865acbcd5bb8b0b75a7f9d2949069b8243f4e19c9b24d957ed6d965_big_gallery.jpeg","isStack":false,"diagnosticCertainty":"confirmed_substantiated"},{"imageId":19832659,"studyId":46475,"caseSlug":"salter-harris-type-ii-wrist-growth-plate-injury","caption":"Case 9: type II","thumbnail":"https://prod-images-static.radiopaedia.org/images/19832659/80b3c4d0e889d56fc3fc343bd99045_big_gallery.jpeg","isStack":false,"diagnosticCertainty":"confirmed_substantiated"},{"imageId":2950122,"studyId":21764,"caseSlug":"salter-harris-fracture-3","caption":"Case 10: type I","thumbnail":"https://prod-images-static.radiopaedia.org/images/2950122/e741ba928f9c03dcbd9ea00b6b338b_big_gallery.JPEG","isStack":false,"diagnosticCertainty":"confirmed_substantiated"},{"imageId":24089974,"studyId":51282,"caseSlug":"ankle-fracture-salter-harris-type-ii","caption":"Case 11: type II","thumbnail":"https://prod-images-static.radiopaedia.org/images/24089974/da26c6c594b3c0ab8edb84280345f8_big_gallery.jpeg","isStack":false,"diagnosticCertainty":"confirmed_substantiated"},{"imageId":28484811,"studyId":56885,"caseSlug":"salter-harris-type-iv-fracture-of-distal-tibia","caption":"Case 12: type IV","thumbnail":"https://prod-images-static.radiopaedia.org/images/28484811/ad66927e2ee164bd9ebaff02b381b2769e621b99b671ac21137da36b52832a70_big_gallery.jpeg","isStack":false,"diagnosticCertainty":"confirmed_substantiated"},{"imageId":49299664,"studyId":78313,"caseSlug":"salter-harris-iv-of-the-proximal-phalanx","caption":"Case 13: type IV displaced","thumbnail":"https://prod-images-static.radiopaedia.org/images/49299664/6676246ff679803961e6d1251ca8d2_big_gallery.jpeg","isStack":false,"diagnosticCertainty":"confirmed_substantiated"},{"imageId":35537251,"studyId":65085,"caseSlug":"triplane-fracture-5","caption":"Case 14: type IV (triplane fracture) ","thumbnail":"https://prod-images-static.radiopaedia.org/images/35537251/b8ee2d4c11c6594411e6f7fe900e372d343bc514fbec9cb281b9acab47ae4b28_big_gallery.jpeg","isStack":true,"diagnosticCertainty":"confirmed_substantiated"},{"imageId":53725946,"studyId":98504,"caseSlug":"salter-harris-type-ii-fracture-fifth-finger","caption":"Case 15: type II","thumbnail":"https://prod-images-static.radiopaedia.org/images/53725946/001_big_gallery.jpeg","isStack":false,"diagnosticCertainty":"confirmed_substantiated"},{"imageId":54037561,"studyId":100478,"caseSlug":"salter-harris-4-fracture-of-index-finger-middle-phalanx","caption":"case 15: type IV","thumbnail":"https://prod-images-static.radiopaedia.org/images/54037561/XR_FINGER_RIGHT_20201210_073226_big_gallery.jpeg","isStack":false,"diagnosticCertainty":"confirmed_substantiated"}],"ddx_inclusions":[],"lang":"us"}

Updating… Please wait.

Unable to process the form. Check for errors and try again.

Thank you for updating your details.

Salter-Harris classification

Updates to Article Attributes

Classification

Others

Image 22 X-ray (Frontal) ( create )

Articles

By Section:

By System:

Cases

Radiopaedia.org