Salter Harris Fracture Classification

Salter Harris fractures occur in growing children. The fractures happen through and around the growth plates at the end of long bones, like the femur, humerus, or radius. There are officially five classifications of Salter Harris fractures, identifying the location and component of the injured bone and growth plate. If a Salter Harris fracture is suspected, it is important to consult with the appropriate health care provider to receive proper treatment.

Anatomy

• It is important to understand the anatomy surrounding a growth plate to get a clear picture of the classifications of Salter Harris fractures. These fractures involve the metaphysis, growth plate and epiphysis of long bones in children. The growth plate is a thin space at the end of long bones between the metaphysis and epiphysis. The metaphysis is the area of the bone immediately above the growth plate. The epiphysis is below the growth plate and at the end of the bone.

Classification

• Salter Harris fractures are classified Type I through Type V. Salter Harris Type I is a fracture through the growth plate alone. Type II is a fracture through the metaphysis and the growth plate. Type III is a fracture through the growth plate and the epiphysis. Type IV is a fracture through the metaphysis, growth plate and epiphysis. Type V is a compression or crush injury to the growth plate alone.

Symptoms

• Salter Harris fractures can occur in children until the growth plates have fused. Symptoms to look for that may be related to a Salter Harris fracture are an inability to play after a sudden injury, visible deformity of the arm or leg after an injury, severe pain that prevents the child from using an arm or leg following an injury and a decreased ability to play due to long-term complications after an injury to the arm or leg.

Treatment

• Treatment for Salter Harris fractures varies depending on the classification of the injury. Classification can be identified by X-ray or MRI. Salter Harris fracture Type I generally heal with cast immobilization and very rarely require surgical intervention. Type II may heal well with cast immobilization, as long as the fragments are aligned. Type II will sometimes require surgery if the fragments have been displaced. Salter Harris fractures Types III through V often require surgical intervention and may result in arrested growth of the bone.