Salter-Harris classification
Citation, DOI & article data
- SH types
- Salter-Harris fracture classification
The Salter-Harris classification was proposed by Salter and Harris in 1963 1 and, at the time of writing (January 2023) remains the most widely used system for describing physeal fractures.
Classification
Conveniently the Salter-Harris types can be remembered by the mnemonic SALTR.
-
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
-
above
~75% (by far the most common)
fracture passes across most of the growth plate and up through the metaphysis
good prognosis
-
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
-
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
-
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 that 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
Quiz questions
References
- 1. Salter R, Harris WR. Injuries Involving the Epiphyseal Plate. J Bone Joint Surg Am 1963. 45 (3) 587-622. Read at J Bone Joint Surg Am
- 2. Ralph Weissleder, Jack Wittenberg, Mukesh G. Harisinghani. Primer of Diagnostic Imaging. (2003) ISBN: 0323023282 - Google Books
- 3. Mercer Rang, Maya E. Pring, Dennis Ray Wenger. Rang's Children's Fractures. (2005) ISBN: 9780781752862 - Google Books
- 4. Little J, Klionsky N, Chaturvedi A, Soral A, Chaturvedi A. Pediatric Distal Forearm and Wrist Injury: An Imaging Review. Radiographics. 2014;34(2):472-90. doi:10.1148/rg.342135073 - Pubmed
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