Case Study: The Salter-Harris Classification

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The Salter-Harris classification is a radiologic classification system, developed in the 1960s, to describe fractures involving the growth plate in pediatric patients.1 It divides the fractures into five categories based on the extent of damage to the growth plate based on the mnemonic SALTER; type I: Slip or Separation of the growth plate, type II: Above the growth plate, type III: Lower than the growth plate, type IV: Through the growth plate, and type V: Raised epiphysis. Children have open growth plates until after adolescence, so this area is more susceptible to injury.1 Injury to the growth plates can result in length discrepancy and growth plate arrest, angular deformation, or altered joint mechanics which may cause significant long term disability (Physeal Injuries) if the injury is not properly diagnosed and appropriately treated.1 Higher grades imply an increased likelihood of eventual growth disturbance. (Ped.Distal)
Anatomy
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(Physeal Injuries) Traction epiphyses, or apophyses, are located at the site of attachment of major muscle tendons to bone and are subjected primarily to tensile forces. (Physeal Injuries) Apophyses contribute to bone shape but not to longitudinal growth. (Physeal Injuries) Longitudinal growth, which occurs during childhood and adolescence, occurs at the growth plates where cartilage proliferates in the epiphyseal and metaphyseal areas of long bones, before undergoing mineralization to form primary bones. (Normal Bone) The growth plate is located between the epiphysis and metaphysis and is the essential mechanism of endochondral ossification. (Physeal

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