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Types of Growth Plate Injuries
Salter-Harris Classification Type Category Type of Damage I Fracture through the growth plate: The epiphysis is completely
separated from the end of the bone or the metaphysis, through the deep layer of the growth plate. The growth plate remains attached to the epiphysis. The doctor has to put the fracture back into place if it is significantly displaced. Type I injuries generally require a cast to protect the plate as it heals. Unless there is damage to the blood supply to the growth plate, the likelihood that the bone will grow normally is excellent. II Fracture through the growth plate and metaphysis: This is
the most common type of growth plate fracture. It runs through the growth plate and the metaphysis, but the epiphysis is not involved in the injury. Like type I fractures, type II fractures may need to be put back into place and immobilized. However, the growth plate fracture heals a great deal, especially in younger children. If it is not too displaced, the doctor may not need to put it back into position. In this case, it will strengthen with time. III Fracture through growth plate and epiphysis: This fracture occurs only rarely, usually at the lower end of the tibia, one of the long bones of the lower leg. It happens when a fracture runs completely through the epiphysis and separates part of the epiphysis and growth plate from the metaphysis. Growth Plate Injuries Surgery is sometimes necessary to restore the joint surface to normal. The outlook or prognosis for growth is good if the blood supply to the separated portion of the epiphysis is still intact and if the joint surface heals in a normal position. IV Fracture through growth plate, metaphysis, and epiphysis: This fracture runs through the epiphysis, across the growth plate, and into the metaphysis. Surgery is frequently needed to restore the joint surface to normal and to perfectly align the growth plate. Unless perfect alignment is achieved and maintained during healing, prognosis for growth is poor, and angulation (bending) of the bone may occur. This injury occurs most commonly at the end of the humerus (the upper arm bone) near the elbow. V Compression fracture through growth plate: This uncommon injury occurs when the end of the bone is crushed and the growth plate is compressed. It is most likely to occur at the knee or ankle. Prognosis is poor, since premature stunting of growth is almost inevitable. Source: U.S. Department of Health and Human Services,
National Institutes of Health, National Institute of Arthritis and Musculoskeletal and Skin Diseases. www.niams.nih.gov