Salter–Harris Classification

Salter RB, Harris WR. Injuries involving the epiphyseal plate. Introduced the five-type classification of paediatric physeal fractures used here, based on radiographic pattern and its relation to the epiphysis and metaphysis, and to the prognosis for growth.

The classification predicts relative risk, not certainty — a growth disturbance can occur after any type, including a type I fracture, and conversely most physeal fractures of any type heal without a problem. Types III and IV are intra-articular and generally need anatomic reduction; type V is often diagnosed only in retrospect, once growth arrest becomes apparent on follow-up. Clinical and radiographic follow-up to detect a growth disturbance is appropriate regardless of type, and any physeal fracture in a child should be assessed by someone experienced in paediatric orthopaedic injuries.