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A break in or nearby a bone's growth plate, also called the epiphyseal plate or physis, is called a Salter Harris fracture. These fractures are only seen in children and adolescents that have not finished growing. The damaged bone cell may grow at an accelerated or decelerated rate, causing noticeable differences in bone lengths. Salter Harris fractures are classified I to IX according to the area of the bone and growth plate damaged by the fracture. The classification of the fracture site may indicate if surgery is necessary to realign and stabilize the fractured bone.
Diagnosis of a Salter Harris fracture is made after a physical examination and an x-ray of the fractured area. Bone pain and bruising are common symptoms of a Salter Harris fracture, and the skin near the fracture will likely be painful to the touch. Swelling around the area usually occurs shortly after the injury happens. Painkillers or non-steroidal anti-inflammatory drugs (NSAIDs) may be recommended during the healing period.
The Salter Harris fractures are ranked I through IX, although the last four classifications are rarely used. The type I fracture passes transversely through the epiphyseal plate. After the fracture heals, there is not any residual bone growth problems. Casting to prevent the movement of the bone is done until the fracture heals, usually about four to six weeks.
Type II fractures are breaks through the part of the bone directly above the growth plate, called the metaphysis, extending down into the growth plate. This type of Salter Harris fracture is the most common. The bone is typically cast until the six-week healing period is over. Bone growth usually continues normally after the fracture heals.
A Type III Salter Harris fracture involve the area of bone below the growth plate, and the growth plate itself. Part of the epiphysis may break off, requiring surgery to realign the bone. After the bone is set correctly, it is immobilized in a cast. The healing period for a type III fracture may require up to six weeks.
The Type IV fracture is often associated with disrupted bone growth patterns that may result in lasting disability. It extends from the epiphysis up through the growth plate and into the metaphysis. A surgical alignment is often necessary before the bone may be cast. The fractured bone generally heals after four to six weeks of complete rest.
Salter Harris fracture type V nearly always results in a severe decrease in bone growth and occur when the growth plate is crushed between the epiphysis and the metaphysis. Surgical treatment to stabilize the bone and resurface the joint may be necessary. The bone will take about four to six weeks to heal after the cast is applied, and physical therapy may be required after the cast is removed to encourage easy mobility.