Salter Harris fracture and its types

Salter-Harris fracture is one which involves eipphyseal plate (growth plate) of a bone.

15% of the long bone fractures occurring in childhood are salter harris fractures. Salter-Harris fracture is a common injury in children.

Types of Salter Harris fracture and their incidence

There were 5 types of salter harris fractures described by Robert B salter and W Robert Harris in 1963. However, 4 more rarer types were added subsequently added later making total 9 types of salter-harris fractures.

• TYPE I – V (described by Salter & Harris in 1963)
  1. TYPE I : Transverse fracture through the physis (growth plate) – 6% incidence
  2. TYPE II : Fracture through the physis and metaphysis, sparing the epiphysis – 6% incidence
  3. TYPE III : Fracture through physis and epiphysis, sparing the metaphysis – 75% incidence
  4. TYPE IV : A fracture through all 3 elements of bone, physis, metaphysis and eipphysis – 10% incidence
  5. TYPE V : A compression fracture of physis (growth plate). This results in reduced space between epiphysis and diaphysis on x-ray – 1% incidence
• TYPE VI (Added by Mercer Rang in 1969)
  • TYPE VI : Injury to the peripheral portion of the physis resulting in angular deformity as a result of bony ridge formation
• TYPE VII – IX (Added by JA Ogden in 1982)
  • TYPE VII : Isolated injury of epiphyseal plate
  • TYPE VIII : Isolated injurty of metaphysis with possible impairment of endochondral ossification
  • TYPE IX : Injury to the periosteum with possible impairment of intramembranous ossification

Mnemonic for Salter Harris Classification of fractures

There’s a mnemonic for first five types of salter harris types of salter harris fractures.

Mnemonic for salter harris classification of fracutes is: S A L T R

Imagine a long bone with eipphyses at the base, then this mnemonic “SALTR” goes like this:

• I – S = Straight accross (separated / same). Fracture of the physis (cartilage of growth plate)
• II – A = Above. The fracture is ABOVE the physis and AWAY from the joint.
• III – L = Lower. The fracture is beLOW the physis in the epiphysis.
• IV – T = Thrugh. The fracture is through all 3, epiphysis, physis and metaphysis
• V – R = Rammed (crushed). The physis is crushed in this type.