Salter-Harris classification

The Salter-Harris classification was proposed by Salter and Harris in 1963 1 and at the time or 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

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Article Information

rID: 2017
Section: Classifications
Synonyms or Alternate Spellings:
  • Salter-Harris gracture classification
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    Figure 1: normal
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    Case 1: type I
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    Figure 2: type I
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    Case 2: type II 
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    Figure 3: type II
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    Case 3: type IV
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    Figure 4: type III
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    Case 4: type II
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    Figure 5: type IV
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    Case 5: type I
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    Figure 6: type V
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    Case 6: type I
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    Case 7: type III (with concurrent talar fracture)
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    Case 8: type I
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    Case 9: type II
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    Case 10: Type I
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    Case 11: Type II
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