The Different Types of Salter-Harris Fractures

Salter-Harris fracture is a name given to a fracture or physical injury to the growth plate of a long bone such as the tibia or humerus. Typical examples of Salter-Harris fractures occur in children's growth plates, known as the physeal or epiphyseal plate.

The growth plate is an area of cartilage that develops into new bone formation, gradually increasing the bone's length until the child stops growing at around 14 to 18. Any failure to diagnose and treat a Salter-Harris fracture in the growth plate can lead to permanent growth arrest, which means the bone stops growing entirely. 

Salter-Harris fractures are the most common types of fractures found in children and can result in permanent bone deformity or stunted growth at a young age. 

There are different types of Salter-Harris fractures. In addition to a type II fracture, which is the most common, there are four other types in the Salter-Harris classification system. These are numbered according to how severely the fracture will affect bone growth. Type I being the least significant, and type V being the most. These include:

• Type I Salter-Harris fracture: This fracture line runs straight across the growth plate. It involves fracturing the cartilage but won't affect the bone. Type I can cause the rounded end of the bone, the epiphysis, to become separated from the rest of the bone. 
• Type II Salter-Harris fracture: This is the most common physeal fracture in children, usually occurring in those aged ten years and over. Type II fractures are breaks at an angle that cuts through most of the growth plate and the metaphysis, which sits just above the growth plate. The separated piece of the metaphysis is called a Thurston-Holland fragment.
• Type III Salter-Harris fracture: These are a rare occurrence, usually affecting the distal tibia and cutting across the growth plate towards the epiphysis. This type of fracture may lead to the patient developing posttraumatic arthritis, characterized by inflammation or swelling around the joint. 
• Type IV Salter-Harris fracture: These run vertically through the growth plate and can lead to asymmetric bone growth or deformity. 
• Type V Salter-Harris fracture: This is extremely rare and happens when the growth plate becomes damaged but there is no actual break. 

Note: Fracture types III to V are more likely to lead to growth arrest than types I and II. 

PDUK provides professional training courses for healthcare providers and medical practitioners such as nurses, clinicians and allied healthcare workers. We highly recommend the following one-day online workshop in X-ray interpretation.

AR07 X-ray interpretation of minor injuries- includes Red Dot- Online

This one-day interactive online workshop looks at the clinical presentation with relevant anatomy and principles of x-ray interpretation. The workshop also covers other essential elements such as patient assessment, radiographic referral, interpretation and treatment for minor injuries.

This workshop is primarily aimed at healthcare practitioners that use X-ray interpretation as part of their role. Still, the workshop is also suitable for healthcare providers who make X-rays referrals. Participants should already be familiar with X-ray interpretation.

This workshop is valuable for healthcare practitioners working within minor injury units, A&E departments, out of hour's services and walk-in centres. It is an ideal course for nurse practitioners, ENPs, Medical students and allied health professionals.

Workshop participants can expect to gain knowledge in the following:

• Demonstrate the ability to integrate the basic anatomy of the upper and lower limb with history taking, mechanism of injury and clinical assessment skills concerning radiological referral.
• Make appropriate referrals for X-rays.
• Develop a systematic approach to X-ray interpretation.

The workshop runs from 09:30 am- 4:30 pm and includes all equipment, course materials, evaluation and certificate of attendance.