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Salter-Harris Fractures
BY JORGE MUNIZ, PA-C

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 Pediatric physeal fractures have traditionally been described by the !ve-part Salter-Harris
classi!cation system.

Type I fractures occur through the growth plate. These injuries may present with normal
radiographs and the diagnosis is often made clinically when tenderness is palpated over the
growth plate.

Type II fractures occurs through the growth plate and metaphysis. Type II injuries are the
most common physeal fractures.

Type III fractures occur through the growth plate and epiphysis. Type III injuries are intra-
articular and the diagnosis is made radiographically based on the appearance of an
epiphyseal fragment not associated with a metaphyseal fracture.

Type IV fractures are also intra-articular and occur through the growth plate, metaphysis
and epiphysis.

Type V fractures occur when there is a crush injury of the growth plate. The prognosis is
poor because growth arrest and partial physeal closure are common.

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