IN THIS LESSON

Bone fractures are classified by their pattern, cause and where they happen.

When consulting, always include the following information:

Pattern: What is the shape of a break or what does the break look like?

Cause: What is the mechanism of injury?

Location: Which bone was impacted?

A deeper dive into patterns:

Use the following descriptors when documenting or discussing fractures. This helps guide treatment decisions and allows for more accurate counseling on expected recovery time.

  • Greenstick: A partial fracture where the bone bends and cracks on one side, common in children

  • Transverse: A fracture that occurs straight across the bone, typically due to a direct blow

  • Comminuted: A fracture in which the bone is broken into three or more pieces

  • Spiral: A fracture caused by a twisting force, resulting in a helical break around the bone

  • Compound: Also known as an open fracture, where the bone breaks through the skin, increasing the risk of infection

It is important to note that pediatric bones come with a growth plate, that can sometimes be mistakenly interpreted as a fracture. Growth plates are also called the physis. Each long bone has at least two growth plates, one at each end, and they are longer than they are wide.

Salter Harris (SH) Classification

  1. Type I: Fracture through physis only (growth plate); ~6% of cases.

  2. Type II: Through physis and metaphysis; most common (~75%); heals in 2–3 weeks.

  3. Type III: Through physis and epiphysis; ~8%.

  4. Type IV: Through metaphysis, physis, and epiphysis; ~10%.

  5. Type V: Crush injury to physis; rare (~1%); may appear as decreased growth plate space on x-ray.