Salter-Harris fractures are epiphyseal plate fractures and are common and important as they can result in premature

closure and therefore limb shortening and abnormal growth. They represent approximately 35% of all skeletal injuries in children, and typically occur in the 10-15 year old child. The growth plate has 5 distinctive zones. Fractures tend to propagate along the weakest zone, which is the spongiosum. Fortunately this is not a region of active growth, and therefore fractures through this area have a good prognosis. When the fracture passes towards the epiphysis, it passes through the zones of proliferation and reserve which result in possible premature closure of the growth plate at the fracture site. Conveniently the Salter-Harris types can be remembered by the mnemonic SALTR.

o o o o o o o o o o o o o o o o o o o o o o

type I slipped 5-7% fracture plane passes all the way through the growth plate, not involving bone cannot occur if the growth plate is fused reference required good prognosis type II above ~ 75% (by far the most common) fracture passes across most of the growth plate and up through themetaphysis good prognosis type III lower 7-10% fracture plane passes some distance along the growth plate and down through the epiphysis poorer prognosis as the proliferative and reserve zones are interrupted type IV through or transverse or together intra-articular 10% fracture plane passes directly through the metaphysis, growth plate and down through the epiphysis poor prognosis as the proliferative and reserve zones are interrupted type V ruined or rammed uncommon < 1% crushing type injury does not displace the growth plate but damages it by direct compression worst prognosis

There are a few other rare types which you should probably never include in a report as almost no one will know what you are talking about. Nonetheless they are:

type VI - injury to the perichondral structures type VII - isolated injury to the epiphyseal plate type VIII - isolated injury to the metaphysis, with a potential injury related to endochondral ossification type IX - injury to the periosteum that may interfere with membranous growth

_________
Torus fractures (also known as buckle fractures) are incomplete fractures of the shaft of a long bone that is characterised by bulging of the cortex. They usually result from trabecular compression from an axial loading force (along long axis of bone). Usually seen in children, frequently involving the distal radial metaphysis.

Pathophysiology
Cortical buckle fractures occur when there is axial loading of a long bone. This most commonly occurs at the distal radius following a fall on an outstretched arm: the force is transmitted from carpus to the distal radius and the point of least resistance fractures - usually the dorsal cortex of the distal radius.

Radiographic features
Plain film

distinct fracture lines are not seen subtle deformity or buckle of the cortex may be evident in some cases, angulation is the only diagnostic clue

Treatment and prognosis

They are self limiting and do not require operative intervention. Sometimes a cast may be applied, but often a splint is all that is required with period of rest and immobilisation.

Etymology
The term torus is derived from the Latin word tori which means protuberance.