Salter Harris Classification
Salter Harris Type I: Fracture passes through physis
Salter Harris Type II: Fracture through metaphysis and physis
Salter Harris Type III: Fracture of physis and epiphysis
Salter Harris Type IV: Fracture passes vertically through physis / metaphysis, physis and epiphysis
Salter Harris Type V. Crushing of part or all of the epiphysis
Other pediatric fracture patterns
Buckle or Torus fracture
- metaphyseal-diaphyseal junction
- compression fracture
- compression side has undergone plastic deformation
Greenstick Fracture
- diaphyseal injury
- failure tension side
- plastic deformity compression side
Plastic Deformity
- microscopic failure
- forearm and fibula
Physeal anatomy
| Reserve zone | Proliferative zone | Hypertrophic zone |
|---|---|---|
|
Few cells, high matrix Cells from Groove of Ranvier Cells quiescent |
Cellular proliferation / mitosis Columns of cells Longitudinal growth Metaphyseal side |
A. Maturation - enlarged, swollen, vacuolated
B. Degeneration - increase alk phosphatasi increases phosphate for calcification
C. Provisional calcification - extracellular matrix calcify - cell death |
Physeal fractures
Thought to occur primarily through hypertrophic zones