In the Salter-Harris classification, what does grade IV involve?

In the Salter-Harris classification system, which is used to categorize pediatric fractures involving the growth plate (physis), grade IV specifically refers to a fracture that affects the epiphysis, metaphysis, and physis. This means that the fracture extends through all three of these anatomical areas.

The involvement of the epiphysis is significant because it can affect the future growth of the bone, leading to potential complications such as growth arrest or deformity. Grade IV fractures can be more complex and may require careful management to optimize healing and preserve function.

Understanding the structure of these areas is crucial. The physis is the growth plate, the metaphysis is the region where the diaphysis (shaft of the bone) meets the epiphysis (end of the bone), and the epiphysis is the area at the end of the bone that contributes to joint formation. Since grade IV impacts all three regions, it underscores the importance of careful assessment and intervention for fractures of this type.

This classification helps in forecasting potential complications and guiding the treatment plan to ensure the best possible outcome for the child.