A fracture involving the epiphyseal plate (growth plate) of a bone, specifically the zone of provisional calcification.
Commonly found in children, accounting for 15% of childhood long bone fractures.
Named after Robert B. Salter and William H. Harris.
Classification published in the Journal of Bone and Joint Surgery in 1963.
Types of Salter-Harris Fractures
Type I: Transverse fracture through the growth plate (physis)
Incidence: 6%
Type II: Fracture through growth plate and metaphysis, sparing epiphysis
Incidence: 75%
Healing time: Approximately 12-90 weeks in spine
Type III: Fracture through growth plate and epiphysis, sparing metaphysis
Incidence: 8%
Type IV: Fracture through growth plate, metaphysis, and epiphysis
Incidence: 10%
Type V: Compression fracture of the growth plate
Incidence: 1%
Type VI: Injury to peripheral portion of physis, potential angular deformity (added in 1969 by Mercer Rang)
Type VII: Isolated injury of the epiphyseal plate (added in 1982 by JA Ogden)
Type VIII: Isolated injury of the metaphysis, potential impairment of endochondral ossification
Type IX: Injury of the periosteum, potential impairment of intramembranous ossification
Mnemonic for Classification (SALTR)
Type I (S): Slip - Fracture of the cartilage of the physis
Type II (A): Above - Fracture above the physis, away from the joint
Type III (L): Lower - Fracture below the physis in the epiphysis
Type IV (TE): Through Everything - Fracture through metaphysis, physis, and epiphysis
Type V (R): Rammed - Physis is crushed
Healing and Prognosis
Fractures often heal quickly in children, usually within weeks.
Most growth plate fractures heal without lasting effects.
Rare complications include bridging bone formation, stunted growth, or bone curving, which may require surgical intervention.
Growth plate fractures can stimulate growth, potentially causing one bone to become longer than its counterpart.
Regular follow-up recommended for at least a year after a growth plate fracture by the American Academy of Orthopaedic Surgeons.
Additional Information
Salter-Harris fractures can be identified using radiographs.
Images available demonstrate Salter-Harris I-IV fractures in different bones.
References
Various studies and textbooks, including works by Salter and Harris, Clinical Orthopaedics and Related Research, and Journal of Pediatric Orthopaedics.