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Salter-Harris Type IV Fracture of the proximal middle phalanx


Red=Metaphyseal fracture; Blue=Epiphyseal fracture

Background

     Children commonly sustain injuries of the physis because the cartilaginous growth zone that bridges the physis is weaker than bones and ligaments.  Salter-Harris classification is used to describe five patterns of physeal injuries.

     The most feared complication of physeal fractures is premature growth cessation, resulting in shortening of the affected bone.  This is most likely to occur with Salter-Harris types III, IV, and V fractures.  Because the germinal layer of the growth plate is not involved in types I and II, growth disturbances are less likely to occur with these fractures.

     The relative prevalence of the various Salter-Harris fracture types is as follows: type I, 6% of all physeal fractures; type II, 75%; type III, 8%; type IV, 10%; type V, 1%.

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January 28, 2010
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