Differential diagnosis of Salter-Harris fractures

• Salter-Harris Type I fracture (through physis)
• Salter-Harris Type II fracture (through physis and metaphysis)
• Salter-Harris Type III fracture (through physis and epiphysis)
• Salter-Harris Type IV fracture (through epiphysis to metaphysis)
• Salter-Harris Type V fracture (crush injury to physis)
• Slipped capital femoral epiphysis
• Little Leaguer shoulder
• Apophyseal fracture

Approach to the differential diagnosis of Salter-Harris fractures:

• A unique way that children’s bones differ from adult’s bones is that children’s ligaments are stronger than their bones which leads to Salter-Harris metaphyseal / epiphyseal fractures
• Remember that the higher the grade of Salter-Harris fracture, the more likely the development of the serious complication of Salter-Harris fractures of premature growth plate fusion
• Have a high index of suspicion for a bony bridge forming across growth plate during healing, which can lead to premature fusion of growth plate and limb length discrepancy
• Do not confuse apophyseal fractures with Salter-Harris fractures