Salter-Harris classification: Difference between revisions
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| Line 39: | Line 39: | ||
|Type I | |Type I | ||
| | | | ||
* Frequency: 5-7% | * Frequency: 5-7% | ||
* cannot occur if the growth plate is fused cit | * cannot occur if the growth plate is fused cit | ||
* good prognosis | * good prognosis | ||
* Mechanism: Fractured plane involved the whole growth plate, not involving bone | * Mechanism: Fractured plane involved the whole growth plate, not involving bone | ||
* Origin: through the growth plate | |||
|[[File:Type1-Salter-Harris classification.jpg|alt=courtesy of DrMars, <https://www.wikidoc.org>|thumb|'''''Type 1-Salter-Harris classification''''']] | |[[File:Type1-Salter-Harris classification.jpg|alt=courtesy of DrMars, <https://www.wikidoc.org>|thumb|'''''Type 1-Salter-Harris classification''''']] | ||
|[[File:Salter-Harris type I injury of shoulder.jpg|thumb|'''Salter-Harris type I injury of shoulder''']] | |[[File:Salter-Harris type I injury of shoulder.jpg|thumb|'''Salter-Harris type I injury of shoulder''']] | ||
| Line 49: | Line 49: | ||
|Type II | |Type II | ||
| | | | ||
* Frequency: 75% | * Frequency: 75% | ||
* good prognosis | * good prognosis | ||
* Mechanism: Fractured plane involved most of the growth plate and up through the metaphysis | * 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 | ||
|[[File:Type 2 Salter-Harris classification.jpg|alt=courtesy of DrMars, <https://www.wikidoc.org>|thumb|'''''Type 2 Salter-Harris classification''''']] | |[[File:Type 2 Salter-Harris classification.jpg|alt=courtesy of DrMars, <https://www.wikidoc.org>|thumb|'''''Type 2 Salter-Harris classification''''']] | ||
|[[File:Salter-Harris type II injury of ankle.jpg|thumb|'''Salter-Harris type II injury of ankle''']] | |[[File:Salter-Harris type II injury of ankle.jpg|thumb|'''Salter-Harris type II injury of ankle''']] | ||
| Line 59: | Line 58: | ||
|Type III | |Type III | ||
| | | | ||
* Frequency: 7-10% | * Frequency: 7-10% | ||
* cannot occur if the growth plate is fused cit | * 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 | * Mechanism: Fractured plane involved the growth plate through the epiphysis | ||
* | * Origin: through growth plate and epiphysis, sparing the metaphysis | ||
|[[File:Type 3 Salter-Harris classification.jpg|alt=courtesy of DrMars, <https://www.wikidoc.org>|thumb|'''''Type 3 Salter-Harris classification''''']] | |[[File:Type 3 Salter-Harris classification.jpg|alt=courtesy of DrMars, <https://www.wikidoc.org>|thumb|'''''Type 3 Salter-Harris classification''''']] | ||
|[[File:Salter-Harris type III injury of ankle.jpeg|thumb|'''Salter-Harris type III injury of ankle''']] | |[[File:Salter-Harris type III injury of ankle.jpeg|thumb|'''Salter-Harris type III injury of ankle''']] | ||
| Line 70: | Line 68: | ||
|Type IV | |Type IV | ||
| | | | ||
* Frequency: 10% | * Frequency: 10% | ||
* cannot occur intra-articular | * 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 | * 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 | ||
|[[File:Type 4- Salter-Harris classification.jpg|alt=courtesy of DrMars, <https://www.wikidoc.org>|thumb|'''''Type 4- Salter-Harris classification''''']] | |[[File:Type 4- Salter-Harris classification.jpg|alt=courtesy of DrMars, <https://www.wikidoc.org>|thumb|'''''Type 4- Salter-Harris classification''''']] | ||
|[[File:Salter-Harris type IV injury of foot.jpg|thumb|'''Salter-Harris type III injury of foot''']] | |[[File:Salter-Harris type IV injury of foot.jpg|thumb|'''Salter-Harris type III injury of foot''']] | ||
| Line 82: | Line 79: | ||
|Type V | |Type V | ||
| | | | ||
* Frequency: <1% | * Frequency: <1% | ||
* cannot occur if the growth plate is fused cit | * 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 | * 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 | ||
|[[File:Type 5 Salter-Harris classification.jpg|alt=courtesy of DrMars, <https://www.wikidoc.org>|thumb|'''''Type 5 Salter-Harris classification''''']] | |[[File:Type 5 Salter-Harris classification.jpg|alt=courtesy of DrMars, <https://www.wikidoc.org>|thumb|'''''Type 5 Salter-Harris classification''''']] | ||
| | | | ||
|- | |- | ||
|Rare Types: Type VI | |Rare Types: Type VI | ||
| | | | ||
* An isolated damage of the perichondral structures | |||
| | | | ||
| | | | ||
Revision as of 22:20, 18 April 2019
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 |  |
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| Type I |
|
 |
 |
| Type II |
|
 |
 |
| Type III |
|
 |
 |
| Type IV |
|
 |
 |
| Type V |
|
 |
|
| Rare Types: Type VI |
|
||
| Rare Types: Type VII |
|
||
| Rare Types: Type VIII |
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||
| Rare Types: Type IX |
|
See also