Type I A type 1 fracture is transverse fracture through the hypertrophic zone of the physis. In this injury, the width of the physis is increased. The growing zone of the physis usually is not injured, and growth disturbance is uncommon. On clinical examination, the child has point tenderness at the epiphyseal plate, which is suggestive of a type I fracture.
	Type II A type II fracture is a fracture through the physis and metaphysis, but the epiphysis is not involved in the injury. These fractures may cause minimal shortening; however, the injuries rarely result in functional limitations. Type II is the most common Salter-Harris fracture.
	Type III A type III fracture is a fracture through the physis and the epiphysis. This fracture passes through the hypertrophic layer of the physis and extends to split the epiphysis, inevitably damaging the reproductive layer of the physis. This type of fracture is prone to chronic disability because, by crossing the physis, it extends into the articular surface of the bone. However, type III fractures rarely result in significant deformity; therefore, they have a relatively favorable prognosis. A type of ankle fracture termed a Tillaux fracture is a type of Salter-Harris type III fracture that is prone to disability. The treatment for this fracture often is surgical.
	Type IV A Type IV fracture involves all 3 elements of the bone: The fracture passes through the epiphysis, physis, and metaphysis. Similar to a type III fracture, a type IV fracture also is an intraarticular fracture; thus, it can result in chronic disability. By interfering with the growing layer of cartilage cells, these fractures can cause premature focal fusion of the involved bone. Therefore, these injuries can cause deformity of the joint.
	Type V A type V injury is a compression or crush injury of the epiphyseal plate with no associated epiphyseal or metaphyseal fracture. This fracture is associated with growth disturbances at the physis. Initially, diagnosis may be difficult, and it often is made retrospectively after premature closure of the physis is observed. In the older teenagers, the diagnosis is particularly difficult. The clinical history is paramount in the diagnosis of this fracture. A typical history is that of an axial load injury. These injuries have a poor functional prognosis.

When all types of Salter-Harris fractures are considered, the rate of growth disturbance is approximately 30%. However, only 2% of Salter-Harris fractures result in a significant functional disturbance.

Rare types of Salter-Harris fractures include the following:

	Type VI: This is a rare injury and consists of an injury to the perichondral structures.
	Type VII: This is an isolated injury to the epiphyseal plate.
	Type VIII: This is an isolated injury to the metaphysis, with a potential injury related to endochondral ossification.
	Type IX: This is an injury to the periosteum that may interfere with membranous growth.

Preferred Examination: Radiography always is the preferred examination in a suspected fracture. The use of another modality should not be considered until appropriate plain film radiography has been performed.

In cases of severe injury in which the patient has acute pain, appropriate radiographic examination of the involved area may be difficult because of inadequate patient positioning. In these cases, CT may be beneficial in evaluating the injury after a radiologist has evaluated the plain radiographs. However, the cost of CT may prohibit its use in all cases in which the area of interest is suboptimally evaluated. CT should be considered only when radiographic findings are insufficient. Typically, an orthopedic surgeon and a radiologist make the decision to perform CT.

If an additional study is performed, its purpose is to determine the appropriate management and assist in surgical planning. Thus, the surgeon performing the operation is best suited to request the imaging study. When further definition of fractures may help in making management decisions or when the injury does not responding to conservative management, the radiologist or orthopedic surgeon can recommend an appropriate examination to perform after plain radiography.

Currently, 2 radiologic examinations can be performed to further evaluate fractures: (1) CT with multiplanar reconstruction and (2) MRI. MRI depicts marrow edema, whereas CT shows cross-sectional bone detail and tomographic multiplanar information. The use of MRI in the evaluation of fractures is described below, but it is still in its infancy. At the present time, MRI is not the standard of care. CT is used more commonly; typically, it is used for planning surgery.