# Salter-Harris — Salter-Harris classification of physeal fractures

> Classifies fractures involving the growth plate in skeletally immature patients.

**Situação:** vigente · **Órgão:** Musculoesquelético · **Órgão emissor:** Orthopedic consensus · **Versão:** 1963 · **Ano:** 1963

## Procedência e vigência
- Família: léxico
- Tipo de lógica: flat
- Modalidade: XR
- Fonte primária: Salter RB, Harris WR. Injuries involving the epiphyseal plate (1963) — https://en.wikipedia.org/wiki/Salter%E2%80%93Harris_fracture
- Última verificação: 2026-06-26
- Última checagem: 2026-06-26

## Categorias

| Código | Rótulo | Critérios | Conduta | Risco | Localizador | Verificado |
| --- | --- | --- | --- | --- | --- | --- |
| 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. | 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. | 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. | 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. | 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. | 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'). | ✓ |

### Citações por categoria
- **I**: Salter RB, Harris WR. Injuries involving the epiphyseal plate (1963) — https://en.wikipedia.org/wiki/Salter%E2%80%93Harris_fracture · 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**: Salter RB, Harris WR. Injuries involving the epiphyseal plate (1963) — https://en.wikipedia.org/wiki/Salter%E2%80%93Harris_fracture · 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**: Salter RB, Harris WR. Injuries involving the epiphyseal plate (1963) — https://en.wikipedia.org/wiki/Salter%E2%80%93Harris_fracture · 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**: Salter RB, Harris WR. Injuries involving the epiphyseal plate (1963) — https://en.wikipedia.org/wiki/Salter%E2%80%93Harris_fracture · 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**: Salter RB, Harris WR. Injuries involving the epiphyseal plate (1963) — https://en.wikipedia.org/wiki/Salter%E2%80%93Harris_fracture · 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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