Salter-Harris Fracture Types: Classification System Mnemonic
Salter-Harris Fractures: Types and classification system explained! Mnemonic and examples of Salter-Harris type I, type II, type III, type IV, and type V fractures.
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Salter-Harris Fractures
What is a Salter-Harris Fracture?
A Salter-Harris fracture is a type of fracture that involves the growth plate (physis) of a bone
Salter-Harris fractures can be categorized into different types using the Salter-Harris classification system
Types of Salter-Harris Fractures:
There are 5 different types of Salter-Harris fractures based on the anatomy (pattern) and prognosis of the fracture:
Type I
Fracture travels straight across the growth plate (physis)
Type II
Fracture involves part of the growth plate (physis) and metaphysis
Type III
Fracture involves part of the growth plate (physis) and epiphysis
Type IV
Fracture travels through the metaphysis, growth plate (physis), and epiphysis
Type V
Growth plate (physis) is crushed
Salter-Harris Fracture Types: Classification system and examples of Salter-Harris type I, type II, type III, type IV, and type V fractures.
Salter-Harris Classification Mnemonic:
Salter-Harris fractures can be remembered using the mnemonic “SALTR”.
This is easy to remember because it’s part of the name!
The mnemonic describes the location of injury in relation to the growth plate (physis).
The “SALTR” Mnemonic:
S (Type I) = Straight across the physis (slipped)
A (Type II) = Above the physis
L (Type III) = Lower/beLow the physis
T (Type IV) = Through the physis
R (Type V) Ruined/cRushed physis
Salter-Harris Fracture Types: Mnemonic to remember the Salter-Harris classification system for type I, type II, type III, type IV, and type V fractures.
Salter-Harris Type I
A Salter-Harris type I fracture travels straight across the growth plate (physis).
A type I fracture can be remembered using the “S” in the “SALTR” mnemonic.
S = Straight across the physis
Type I fractures make up approximately 5-7% of growth plate injuries, and cannot occur if the growth plate is already fused.
The prognosis is excellent, and treatment is usually non-operative.
Salter-Harris Type I Fracture: Example of a Salter-Harris type I fracture (red line). Use the mnemonic to remember the fracture travels straight across the growth plate (physis).
Salter-Harris Type II
A Salter-Harris type II fracture involves part of the growth plate (physis), and then travels above the physis into the metaphysis.
A type II fracture can be remembered using the “A” in the “SALTR” mnemonic.
A = Above the physis
A type II fracture is the most common growth plate injury, making up approximately 75%.
The prognosis is excellent, and treatment is usually non-operative.
Note: Pay attention to the orientation of the bone when using the “SALTR” mnemonic.
In order for the mnemonic to work, the metaphysis must be oriented superior to (above) the physis and epiphysis.
Salter-Harris Type II Fracture: Example of a Salter-Harris type II fracture (red line). Use the mnemonic to remember the fracture involves the physis and metaphysis (above).
Salter-Harris Type III
A Salter- Harris type III fracture involves part of the growth plate (physis), and then travels below the physis into the epiphysis.
A type III fracture can be remembered using the “L” in the “SALTR” mnemonic.
L = Lower or beLow the physis
Type III fractures make up approximately 7-10% of growth plate injuries.
Type III fractures have the potential to become unstable, especially if the joint space is involved.
Treatment may or may not be operative.
Salter-Harris Type III Fracture: Example of a Salter-Harris type III fracture (red line). Use the mnemonic to remember the fracture involves the physis and epiphysis (below).
Salter-Harris Type IV
A Salter-Harris type IV fracture travels through the metaphysis, growth plate (physis), and epiphysis.
A type IV fracture can be remembered using the “T” in the “SALTR” mnemonic.
T = Through the physis
Type IV fractures make up about 10% of growth plate injuries.
Type IV fractures are typically unstable, and they can potentially lead to limb length discrepancies.
As a result, operative management should be considered.
Salter-Harris Type IV Fracture: Example of a Salter-Harris type IV fracture (red line). Use the mnemonic to remember the fracture travels through the metaphysis, physis, and epiphysis.
Salter-Harris Type V
A Salter-Harris type V fracture is a crush injury to the growth plate (physis).
A type V fracture can be remembered using the “R” in the “SALTR” mnemonic.
R = Ruined or cRushed physis
A type V fracture means the growth plate is crushed or “ruined”.
This is the least common type, comprising less than 1% of growth plate injuries.
Type V fractures can be unstable and lead to limb length discrepancies, similar to type IV fractures.
As a result, operative management should be considered.
Salter-Harris Type V Fracture: Example of a Salter-Harris type V fracture (red line). Use the mnemonic to remember the physis is crushed (ruined).
Last updated 11/17/2025
References
Cepela DJ, Tartaglione JP, Dooley TP, Patel PN. Classifications In Brief: Salter-Harris Classification of Pediatric Physeal Fractures. Clin Orthop Relat Res. 2016 Nov;474(11):2531-2537. doi: 10.1007/s11999-016-4891-3. Epub 2016 May 20. PMID: 27206505; PMCID: PMC5052189. Accessed 2025 Nov 14. https://pmc.ncbi.nlm.nih.gov/articles/PMC5052189/
Levine RH, Thomas A, Nezwek TA, et al. Salter-Harris Fracture. [Updated 2023 Aug 10]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Accessed 2025 Nov 14. https://www.ncbi.nlm.nih.gov/books/NBK430688/
Murphy-Zane MS. Growth Plate Fractures. American Academy of Orthopedic Surgeons. Last updated 2025 Aug. Accessed 2025 Nov 14. https://orthoinfo.aaos.org/en/diseases--conditions/growth-plate-fractures/