Developer site: The content shown here is test data.

MyEClinic
MyEClinic
Health Dictionary AI Health Chat Find an Online Doctor
A serene Zen garden with raked sand and smooth stones, symbolising clarity and calm

Health Dictionary

Reliable, easy-to-read patient information on common medical conditions — written in plain language, free of jargon, and grounded in current evidence. Browse the most frequent diagnoses, understand what they mean for everyday life, and learn which steps and questions help you have a focused conversation with your doctor.

Back to skin conditions

Salter-Harris fracture

Introduction

Courtesy of DrMars, <https://www.wikidoc.org>
Salter-Harris classification
Overview[1]

Overview[1]

Injuries leading to the bone fracture affecting the epiphyseal plate, or physis, are important and common in orthopedic medicine and the cause diagnostic and treatment challenges for orthopaedic surgeons. The related incidence rate of these fracture among pedicatric population is 15-20%.

Historical Perspective [2][3][4][5]

Historical Perspective [2][3][4][5]

In 1863, Foucher JT was the first person who described the injuries affecting the epiphyseal plate.

In 1895, Poland J, classified the injuries affecting the epiphyseal plat into the four types.

In 1936 , Aitken AP, defined the specific differences of different types of physes based on their differences in: structure, location, weightbearing status, and susceptibility to injury.

In 1963, two Canadian orthopaedic surgeons, Robert B. Salter (1924–2010) and W. Robert Harris (1922–2005), introduced a physeal fracture classification system according to the anatomy, fracture pattern, and prognosis of bone fracture.

Then, various researchers and physicians tried to expanded the original work of Salter and Harris in order to make it to be to be more comprehensive:

In 1968, Rang M, added a different sixth type of physeal injuries describing the caused damage to the perichondral ring due to the direct open injuries to the affected bone.

In 1981, Ogden JA, described nine types of injuries such as injuries affecting the developing bone’s other growth mechanisms.

Salter-Harris classification

Salter-Harris classification

Type Descrpstion Image Radiography
Normal
courtesy of DrMars, <https://www.wikidoc.org>
Normal Bone
Type I
  • Frequency: 5-7%
  • cannot occur if the growth plate is fused cit
  • good prognosis
  • Mechanism: Fractured plane involved the whole growth plate, not involving bone
  • Origin: through the growth plate
courtesy of DrMars, <https://www.wikidoc.org>
Type 1-Salter-Harris classification
Salter-Harris type I injury of shoulder
Type II
  • Frequency: 75%
  • good prognosis
  • Mechanism: Fractured plane involved most of the growth plate and up through the metaphysis
  • Origin: through the growth plate and the metaphysis, sparing the epiphysis
courtesy of DrMars, <https://www.wikidoc.org>
Type 2 Salter-Harris classification
Salter-Harris type II injury of ankle
Type III
  • Frequency: 7-10%
  • cannot occur if the growth plate is fused cit
  • poorer prognosis as the proliferative and reserve zones are interrupted
  • Mechanism: Fractured plane involved the growth plate through the epiphysis
  • Origin: through growth plate and epiphysis, sparing the metaphysis
courtesy of DrMars, <https://www.wikidoc.org>
Type 3 Salter-Harris classification
Salter-Harris type III injury of ankle
Type IV
  • Frequency: 10%
  • cannot occur intra-articular
  • poor prognosis as the proliferative and reserve zones are interrupted
  • Mechanism: Fractured plane involved directly through the metaphysis, growth plate and down through the epiphysis
  • Origin: through all three elements of the bone, the growth plate, metaphysis, and epiphysis
courtesy of DrMars, <https://www.wikidoc.org>
Type 4- Salter-Harris classification
Salter-Harris type III injury of foot
Type V
  • Frequency: <1%
  • cannot occur if the growth plate is fused cit
  • worst prognosis
  • Mechanism: Fractured plane dose note involved the growth plate but damages it by direct compression
  • Origin: decrease in the perceived space between the epiphysis and metaphysis
courtesy of DrMars, <https://www.wikidoc.org>
Type 5 Salter-Harris classification
Rare Types: Type VI
  • An isolated damage of the perichondral structures
Rare Types: Type VII
  • An isolated damage of the epiphyseal plate
Rare Types: Type VIII
  • An isolated damage of the metaphysis, with a potential injury due to the endochondral ossification
Rare Types: Type IX
  • An isolated damage of the periosteum that may interfere with membranous growth plane
See also

See also


Template:Fractures

Template:WikiDoc Sources

References

References

  1. ↑ Cepela DJ, Tartaglione JP, Dooley TP, Patel PN (November 2016). “Classifications In Brief: Salter-Harris Classification of Pediatric Physeal Fractures”. Clin. Orthop. Relat. Res. 474 (11): 2531–2537. doi:10.1007/s11999-016-4891-3. PMC 5052189. PMID 27206505.
  2. ↑ Loder RT, Swinford AE, Kuhns LR (1997). “The use of helical computed tomographic scan to assess bony physeal bridges”. J Pediatr Orthop. 17 (3): 356–9. PMID 9150026.
  3. ↑ Leary JT, Handling M, Talerico M, Yong L, Bowe JA (June 2009). “Physeal fractures of the distal tibia: predictive factors of premature physeal closure and growth arrest”. J Pediatr Orthop. 29 (4): 356–61. doi:10.1097/BPO.0b013e3181a6bfe8. PMID 19461377.
  4. ↑ Rohmiller MT, Gaynor TP, Pawelek J, Mubarak SJ (2006). “Salter-Harris I and II fractures of the distal tibia: does mechanism of injury relate to premature physeal closure?”. J Pediatr Orthop. 26 (3): 322–8. doi:10.1097/01.bpo.0000217714.80233.0b. PMID 16670543.
  5. ↑ Lemburg SP, Lilienthal E, Heyer CM (November 2010). “Growth plate fractures of the distal tibia: is CT imaging necessary?”. Arch Orthop Trauma Surg. 130 (11): 1411–7. doi:10.1007/s00402-010-1140-1. PMID 20563820.

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mohammadmain Rezazadehsaatlou[2].