Epiphyseal fractures in children - classification by Salter-Harris and Aitken
Epiphyseal fractures are fractures that involve the epiphyseal growth plate in children and teenagers. Classificaton by Salter and Harris that was published in 1963 divides them into five types. It is a modification of previous classifications by Poland (1898) and Aitken (1936). Later, several other rare types of epiphyseal fractures were appended by other authors. Epiphyseal fractures may result in growth disturbances. A mnemonic "SALTR" can aid in memorizing the types for the purporses of examination.
| S-H Type | Description | Mnemonic | Aitken |
|---|---|---|---|
| I | transverse fracture through the growth plate | S = Slip | |
| II | fracture through the growth plate and the metaphysis sparing the epiphysis - most common type | A = Above the physis | I |
| III | fracture throught the growth plate and epiphysis | L = Lower - below the physis | II |
| IV | fracture through the growth plate, metaphysis and epiphysis | T = Through | III |
| V | compression fracture of the growth plate with decreased space between the epiphysis and metaphysis on x-ray | R = Rammed |
References:
1. Beaty JH, Kasser JR. Rockwood and Wilkins’ Fractures in Children. Lippincott Williams & Wilkins; 2010.
2.Salter RB, Harris WR. Injuries Involving the Epiphyseal Plate. J Bone Joint Surg Am. 1963 Apr 1;45(3):587–622
3. Aitken AP. The End Results of the Fractured Distal Tibial Epiphysis. J Bone Joint Surg Am. 1936 Jul 1;18(3):685–91.