Salter-Harris classification of physeal fractures

vigente

Classifies fractures involving the growth plate in skeletally immature patients.

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Escala de categorias

I II III IV V

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Procedência e vigência

Órgão emissor: Orthopedic consensus
Versão: 1963
Ano: 1963
Família: léxico
Tipo de lógica: flat
Modalidade: XR
Fonte primária: Injuries involving the epiphyseal plate
Última verificação: 2026-06-26
Última checagem: 2026-06-26

Lógica de decisão

Forma estruturada (flat). Uma futura calculadora a lê; as categorias abaixo são a superfície legível.

Mostrar a lógica estruturada (JSON)

{
  "categories": [
    "I",
    "II",
    "III",
    "IV",
    "V"
  ]
}

Categorias num relance

Cat.	Significado	Conduta	Risco	Fonte
I	Type I Fracture plane runs transversely through the physis (growth plate) only, separating the epiphysis from the metaphysis without involving either bony segment; radiographs may be normal or show only physeal widening/epiphyseal displacement. Accounts for ~5% of cases. SALTR mnemonic: S = Slip (slipped physis).	Generally treated non-operatively with closed reduction and cast or splint immobilization; surgery is rarely needed.	Lowest-risk type: low propensity for growth disturbance and a favorable prognosis when the germinal layer and physeal blood supply are preserved.	okfonte Wikipedia 'Salter-Harris fracture' Types section + SALTER mnemonic; management and prognosis from StatPearls NBK430688 ('Salter-Harris I and II fractures can be treated with closed reduction, casting, or splinting'; lower types 'less severe and have less of a propensity for growth abnormalities').
II	Type II Fracture extends through the physis and exits obliquely through the metaphysis, sparing the epiphysis, leaving a triangular metaphyseal fragment (Thurston-Holland fragment / corner sign). Most common type (~75%). SALTR mnemonic: A = Above (line continues above the physis, into the metaphysis).	Usually treated non-operatively with closed reduction and cast/splint immobilization; surgery reserved for unstable or irreducible injuries.	Low risk of growth disturbance with a generally favorable prognosis, similar to type I.	okfonte Wikipedia 'Salter-Harris fracture' Types section + SALTER mnemonic (Thurston-Holland fragment); management and prognosis from StatPearls NBK430688 (closed reduction/casting for types I-II; low propensity for growth abnormality).
III	Type III Intra-articular fracture extending through the physis and exiting through the epiphysis, sparing the metaphysis, and crossing the articular surface/cartilage. SALTR mnemonic: L = Lower (fracture below the physis, into the epiphysis).	Often requires open reduction and internal fixation to restore the articular surface, with fixation placed so as not to cross the physis.	Moderate risk: intra-articular and physeal involvement carry a risk of growth retardation, altered joint mechanics, and functional impairment.	okfonte Wikipedia 'Salter-Harris fracture' Types section + SALTER mnemonic; management and prognosis from StatPearls NBK430688 ('usually require open reduction and internal fixation (avoiding crossing the physis)'; risk of growth retardation/altered joint mechanics/functional impairment).
IV	Type IV Intra-articular fracture passing through all three elements — epiphysis, physis, and metaphysis — in a single line crossing the growth plate, involving the articular surface. SALTR mnemonic: TE = Through Everything.	Surgical: typically requires open reduction and internal fixation to anatomically realign the physis and articular surface.	Higher risk of premature physeal fusion/growth arrest, articular incongruity, and functional impairment; higher Salter-Harris types carry greater risk of growth disturbance.	okfonte Wikipedia 'Salter-Harris fracture' Types section + SALTER mnemonic; management and prognosis from StatPearls NBK430688 (ORIF standard; growth retardation/altered joint mechanics; 'higher-grade Salter-Harris fractures have a higher incidence of premature physeal fusion').
V	Type V Crush/compression injury of the physis with no discrete fracture line, damaging the germinal and hypertrophic layers and physeal vascular supply; often radiographically occult, sometimes seen as reduced epiphyseal-metaphyseal distance. Very rare; frequently diagnosed retrospectively. SALTR mnemonic: R = Rammed (crush).	Recognition warrants prompt orthopedic consultation; diagnosis is often delayed and management focuses on monitoring for growth arrest.	Poorest prognosis: high likelihood of growth arrest/premature physeal fusion owing to germinal-matrix and vascular injury.	okfonte Wikipedia 'Salter-Harris fracture' Types section + SALTER mnemonic; management and prognosis from StatPearls NBK430688 (crush of germinal matrix and vascular supply, often retrospective diagnosis; 'poor prognosis leading to bone growth arrest').

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