Pediatric Fractures

Pediatric fractures will be discussed in this section. We'll elaborate more on the classification of these injuries, and how those classifications differ from adult broken bones.

Robert B. Salter M.D. (1924-2010) was a world renowned Canadian orthopedic surgeon who was responsible for the formation of the classification system that, even today, serves as the benchmark identification system of broken bones in children.

The main difference in the skeletal system between adult and children, especially in the long bones of the extremities, is that in children, in particular during their growth years, have growth plates (also called "physes". The growth plates are areas at the end(s) of bones where new bone formation occurs. It is by this new bone growth that bones increase in length.
Unlike injuries that occur in the shafts of bones, in which case there is little difference between children and adults, the nature and severity of a child's broken bone is directly proportionate to the level of involvement of the growth plate.

Why is that so important, you ask?

Well, damage to the growth plate(s) can significantly increase the risk of bone growth disturbance, or even cessation. If part or all a growth plate (physis) is damaged sufficiently, the new bone formation process may stop altogether, resulting in abnormal growth and formation of a bone and/or length discrepancies.

The Salter-Harris Classification system is divided into five major categories, each describing a different injury mechanism as well as its impact on a bone's growth plate.

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