438 Emergency Medicine
for this injury includes early immobilization and referral. Prognosis is usu-
ally good. Salter-Harris IIis the most common type, accounting for
approximately 75% of fractures involving the growth plate. The fracture
occurs through the growth plate and into the metaphysis. Salter-Harris III
occurs when a fracture breaks through the growth plate and into the epi-
physis.Salter-Harris IVinvolves the metaphysis, physis, and epiphysis.
Salter-Harris V is a crush injury to the growth plate and has a high poten-
tial for growth arrest.
A crush injury to the growth plate (a)is known as a Salter-Harris type
V. (c)The patient’s radiograph is consistent with a Salter-Harris type II.
Fractures through the metaphysis, physis, and epiphysis (d)are known as
Salter-Harris type IV. Salter-Harris type I fractures (e)have the best prog-
nosis. The worst prognosis and highest incidence of growth arrest is seen
with type V fractures.