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Salter and Harris classification of epiphyseal injuries

• Salter and Harris fractures occur through the growth plate
• Therefore they are unique to children
• Classified according to degree of involvement of physis, metaphysis and epiphysis
• Classification is important as it
  • Determines treatment
  • Determines prognosis

• Type I - Epiphyseal slip - no fracture
• Type II - Fracture through epiphyseal plate with proximal fragment
• Type III - Fracture through epiphysis extending into the epiphyseal plate
• Type IV - Fracture through both epiphysis and shaft crossing the epiphyseal plate
• Type V - Crush injury causing obliteration of the growth plate

Management

• In general the following statements hold true for Slater and Harris Fractures
  • Type I involve growth plate but growth is rarely disturbed
  • Type II fractures are the most common
  • Type III fractures involve the joint and can result in chronic morbidity
  • Type III fractures often require surgical treatment
  • Type IV fractures can also result in chronic morbidity
  • Type V fractures are difficult diagnose and can result in limb shortening

Bibliography

Patterson J M.  Children's fractures 'not to be missed'.  Hosp Med 2002;  63:  426-428

Last updated: 05 January 2008

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