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Types of Salter and Harris for Fractures Involving the Epiphyseal Growth Plate in Children and Adolescents

Description

Salter and Harris developed a scheme for classifying fractures that involve the epiphyseal plate in children and adolescents. Such fractures can result in a subsequent growth disturbance, depending on the age of the patient and the state of the growth plate. The authors are from Toronto in Canada.


 

Fracture

Type

with separation straight across, through the epiphyseal plate (perpendicular to the long axis of the bone)

I

with separation through the epiphyseal plate (as for Type I), plus a small triangular fragment of bone from the edge of the metaphysis

II

fracture through the epiphysis vertically, then separates along the epiphyseal plate

III

fracture through the epiphysis vertically, across the epiphyseal plate, and extending into the metaphysis

IV

crush injury to the epiphyseal plate

V

 

Interpretation:

• Types III, IV and V were felt to have significant risk of premature growth arrest.

• Types I and II were felt to be free of long term complications such as premature growth arrest.

 

Limitations:

• Types I and II may be associated with premature, localized growth plate closure and should not be viewed as innocuous.

• This does not allow for classification of all epiphyseal and physeal fractures, so that more inclusive classification schemes are favored today.

 


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