Which Salter-Harris type extends through the metaphysis, physis, and epiphysis?

• A. Type IV
• B. Type II
• C. Type III
• D. Type I

Answer: (A)

Growth-plate injuries are classified by how far the fracture line travels through the growth plate and adjacent bone. The injury that traverses metaphysis, physis, and epiphysis does so in all three regions, which is why it fits this type. This pattern is unique to the fourth category. The other patterns involve only two regions (physis with metaphysis, or physis with epiphysis) or just the growth plate itself, or a crush of the growth plate. Because the fracture crosses the entire growth plate and reaches both the metaphysis and epiphysis, it carries a higher risk for growth disturbance and potential joint involvement if the articular surface is affected.