A Salter-Harris fracture is a fracture in the growth plate of a child’s bone. A growth plate is a layer of growing tissue close to the ends of a child's bone. It’s very important to get this condition diagnosed since it can affect a child’s growth.
Salter-Harris fractures can develop in any long bone, ranging from those in the legs to the fingers. Read on to learn more about Salter-Harris fractures and how to diagnose, treat, and prevent them.
What Is a Salter-Harris Fracture?
Salter-Harris fractures are fractures that only happen to the developing bones of children. They are quite common, making up 15% to 30% of all fractures in children.
Growth plate fractures usually happen on the wrist, fingers, and lower leg because of trauma or overuse. Because of this, child pitchers and gymnasts are more likely to develop these fractures. Boys are also more likely to develop this condition since they are more likely to take part in high-risk physical activities.
It’s important to get these fractures diagnosed as soon as possible. They can affect a child’s growth by damaging the growth plates at the ends of their bones. Growth plates are delicate disks made of cartilage present on the ends of long bones of children where growth occurs.
If a growth plate fracture isn’t treated properly or in time, your child’s limbs, wrists, or fingers could become unequal in length or crooked. If you suspect that your child has a fracture, bring them to a doctor right away. If there is a fracture, they will need to see an orthopedist within the first five to seven days of the injury for the best result.
Types of Salter-Harris Fractures
There are several different types of Salter-Harris fractures:
Type I. This is a fracture through the growth plate. This type of fracture is more common in younger children and typically doesn’t affect your child's growth.
Type II. This fracture goes through the wide portion of a long bone and the growth plate but does not affect the end of the bone. This type is the most common and is usually found in children aged 10 and older. Healing is fast and your child's growth usually won’t be affected.
Type III. This goes through the end part of a long bone as well as the growth plate but does not affect the bone shaft. It usually affects children older than 10. Compared to Types I and II, Type III is more likely to cause chronic disability, since it can affect your child's joint. Surgery is often required to treat this.
Type IV. This goes through the growth plate, the wide portion and the end of the long bone. Like Type III, Type IV may affect your child's growth, joint, and can cause chronic disability. Surgery may be necessary.
Type V. The rarest form of Salter-Harris fracture, Type V happens when your child's growth plate is compressed or crushed. Since this is a severe injury, it can lead to the hardening of the growth plate, leading to bone growth arrest. This means your child’s bone may not be able to continue growing.
With a Type V fracture, your child's limb can become crooked or grow to an uneven length.
Symptoms
Your child may have a Salter-Harris fracture if they have symptoms including:
- Tenderness in the area of the suspected fracture
- Swelling in the area of the suspected fracture
- Inability to put weight on the affected area
- Inability to move the affected area
A Salter-Harris fracture does not necessarily cause a joint to look crooked or deformed. If your child is complaining of severe pain, or pain that is not going away — or if they are not using their joint or bearing weight on their limb, then take them to the doctor.
Diagnosis
Salter-Harris fractures are diagnosed through x-rays and an examination.
If your child is in a lot of pain, the doctor may also decide to get a computed tomography (CT) scan or magnetic resonance imaging (MRI) scan to look at the injury after looking at x-rays.
Treatment
Treatment depends on what type of Salter-Harris fracture your child has.
Type I and II fractures are treated with casting and splinting. These are examples of closed reduction, which puts a bone back into place without cutting open the skin.
Type III and IV fractures will probably require open reduction or internal fixation. In an open reduction, a surgeon moves your bone pieces back to where they should be by cutting open your skin. Internal fixation is then used to reconnect the bone pieces using screws, nails, and wires.
Type V fractures are hard to diagnose, so it may take a while to determine if your child has this kind of injury. Once you have this diagnosis, however, you should book an appointment for your child with an orthopedist or bone doctor. This type of fracture is the most likely to result in growth arrest, so it’s important to talk to your doctor about what can be done.
Prevention
Most Salter-Harris fractures happen due to trauma caused by childhood accidents such as falling from a bike or being pushed down during a sports match.
To keep your child from developing Salter-Harris fractures, you can take precautions including:
- Encouraging your child to take more breaks when participating in sports
- Monitoring your child’s sports training during periods of rapid growth, which is when your child may be more likely to develop growth plate fractures
You should also encourage your child to focus on skill development rather than competition and winning. That way, your child will be less likely to get into an accident that can cause Salter-Harris fractures.
