Salter-Harris classification

Salter-Harris classification

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

Overview

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

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

Type	Descrpstion	Image	Radiography
Normal		Normal Bone
Type I	Origin: slipped 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	Type 1-Salter-Harris classification	Salter-Harris type I injury of shoulder
Type II	Origin: above Frequency: 75% good prognosis Mechanism: Fractured plane involved most of the growth plate and up through the metaphysis good prognosis	Type 2 Salter-Harris classification	Salter-Harris type II injury of ankle
Type III	Origin: lower Frequency: 7-10% cannot occur if the growth plate is fused cit good prognosis Mechanism: Fractured plane involved the growth plate through the epiphysis poorer prognosis as the proliferative and reserve zones are interrupted	Type 3 Salter-Harris classification	Salter-Harris type III injury of ankle
Type IV	Origin: through or transverse or together Frequency: 10% cannot occur intra-articular good prognosis Mechanism: Fractured plane involved directly through the metaphysis, growth plate and down through the epiphysis poor prognosis as the proliferative and reserve zones are interrupted	Type 4- Salter-Harris classification	Salter-Harris type III injury of foot
Type V	Origin: ruined or rammed Frequency: <1% cannot occur if the growth plate is fused cit good prognosis Mechanism: Fractured plane dose note involved the growth plate but damages it by direct compression worst prognosis	Type 5 Salter-Harris classification
Rare Types: Type VI	injury to 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

• Humerus fracture

Template:Fractures