Salter-Harris fractures
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| Salter-Harris fractures | |
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| Classification and external resources | |
 An X-ray of the left ankle showing a Salter-Harris type III fracture of medial malleolus. Black arrow demonstrates fracture line while the white arrow marks the growth plate. |
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| eMedicine | radio/613 |
A Salter-Harris fracture is a fracture that involves the epiphyseal plate or growth plate of a bone. It is a common injury found in children, occurring in 15% of childhood long bone fractures.[1]
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[edit] Types
There are nine types of Salter-Harris fractures; types I to V as described by Robert B Salter and W Robert Harris in 1963,[1] and the rarer types VI to IX which have been added subsequently:[2]
- Type I – A transverse fracture through the growth plate (also referred to as the "physis")[3] : 6% incidence
- Type II – A fracture through the growth plate and the metaphysis, sparing the epiphysis:[4] 75% incidence
- Type III – A fracture through growth plate and epiphysis, sparing the metaphysis:[5] 8% incidence
- Type IV – A fracture through all three elements of the bone, the growth plate, metaphysis, and epiphysis:[6] 10% incidence
- Type V – A compression fracture of the growth plate (resulting in a decrease in the perceived space between the epiphysis and diaphysis on x-ray):[7] 1% incidence
- Type VI – Injury to the peripheral portion of the physis and a resultant bony bridge formation which may produce an angular deformity (added in 1969 by Mercer Rang)[8]
- Type VII – Isolated injury of the epiphyseal plate (VII–IX added in 1982 by JA Ogden)[9]
- Type VIII – Isolated injury of the metaphysis with possible impairment of endochondral ossification
- Type IX – Injury of the periosteum which may impair intramembranous ossification
[edit] SALTER mnemonic for classification
The mnemonic "SALTR" can be used to help remember the first five types.[10][11][12] This mnemonic requires the reader to imagine the bones as long bones, with the epiphyses at the base.
- I - S = Same (or Straight across). Fracture of the cartilage of the physis (growth plate)
- II - A = Above. The fracture lies above the physis, or Away from the joint.
- III - L = Lower. The fracture is below the physis in the epiphysis.
- IV - T = Through. The fracture is through the metaphysis, physis, and epiphysis.
- V - R = Rammed (crushed). The physis has been crushed.
[edit] Salter-Harris fracture images
| Salter Harris fracture radiographs with insets showing fracture lines. | |||||||||
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[edit] See also
[edit] References
- ^ a b "Injuries Involving the Epiphyseal Plate". J Bone Joint Surg Am. 45 (3): 587–622. 1963. http://www.ejbjs.org/cgi/reprint/45/3/587. Retrieved 2010-10-12.
- ^ Salter-Harris Fracture Imaging at eMedicine
- ^ S.H. Type I - Wheeless' Textbook of Orthopaedics
- ^ S.H. Type II - Wheeless' Textbook of Orthopaedics
- ^ Salter Harris Type III Frx - Wheeless' Textbook of Orthopaedics
- ^ Salter Harris: Type IV - Wheeless' Textbook of Orthopaedics
- ^ Type V - Wheeless' Textbook of Orthopaedics
- ^ Rang, Mercer, ed. (1968). The Growth Plate and Its Disorders. Harcourt Brace/Churchill Livingstone. ISBN 9780443005688.
- ^ JA Ogden (1982). "Skeletal growth mechanism injury patterns". J Pediatr Orthop 2 (4): 371–377. PMID 7142386.
- ^ Davis, Ryan. Blueprints Radiology. http://books.google.com.au/books?hl=en&lr=&id=coLSTFjlGqcC&oi=fnd&pg=PA12&dq=salter+harris+classification+SALTR&ots=WVQ-ieWDQQ&sig=qd2c4R78GMvcGqvLTa__G1oitQA#PPA83,M1. Retrieved 2008-03-03.
- ^ Gaillard, Frank. "Radiopedia". http://www.radiopaedia.org/index.php?title=SALTR. Retrieved 2008-03-03.[dead link]
- ^ Tidey, Brian. "Salter-Harris Fractures". http://members.fortunecity.com/radrep/id36.htm. Retrieved 2008-03-03.
[edit] External links
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