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)
TYPE I : Transverse fracture through the physis (growth plate) – 6% incidence
TYPE II : Fracture through the physis and metaphysis, sparing the epiphysis – 6% incidence
TYPE III : Fracture through physis and epiphysis, sparing the metaphysis – 75% incidence
TYPE IV : A fracture through all 3 elements of bone, physis, metaphysis and eipphysis – 10% incidence
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.