What Is a Salter-Harris Fracture?

Written by Nichole Owens
Medically Reviewed by Renee A. Alli, MD on June 02, 2025
6 min read

A Salter-Harris fracture is a fracture in the growth plate of a child’s bone. A growth plate is a layer of growing tissue close to the ends of a child’s bone. Growth plates are fragile portions of the bone, responsible for the growth of the bone. It’s very important to get this condition diagnosed, as it can affect a child’s growth.

Salter-Harris fractures can develop in any long bone of a growing child, ranging from those in the legs to the fingers. Read on to learn more about Salter-Harris fractures and how to diagnose, treat, and prevent them.

Salter-Harris fractures are fractures that only happen to the developing bones of children. They are quite common, making up 15%-30% of all fractures in children.

Growth plate fractures usually happen on the wrist, fingers, and lower leg because of trauma or overuse. Because of this, highly active children, such as pitchers and gymnasts, are more likely to develop these fractures. Boys are also more likely to develop this condition because their bodies mature later than girls’.

If a growth plate fracture isn’t treated properly or in time, your child’s limbs, wrists, or fingers could become unequal in length or crooked. If there is a fracture, they will need to see an orthopedist within the first five to seven days of the injury for the best result.

There are several different types of Salter-Harris fractures:

Salter-Harris fracture type 1

This is a fracture through the growth plate. It’s more common in younger children and typically doesn’t affect your child’s growth.

Salter-Harris fracture type 2

This fracture goes through the wide portion of a long bone and the growth plate but does not affect the end of the bone. This type is the most common and is usually found in children aged 10 and older. Healing is fast and your child’s growth usually won’t be affected.

Salter-Harris fracture type 3

This break happens below the growth plate but does not affect the bone shaft. It usually affects children older than 10. It’s more likely to cause chronic disability, as it can affect your child’s joint. Surgery is often required to treat this.

Salter-Harris fracture type 4

This goes through the growth plate and the wide portion and the end of the long bone. Like type 3, type 4 may affect your child’s growth and joint and can cause chronic disability. Your child may need surgery.

Salter-Harris fracture type 5

The rarest form of Salter-Harris fracture, type 5 happens when your child’s growth plate is compressed or crushed. Since this is a severe injury, it can lead to the hardening of the growth plate, leading to bone growth arrest. This means your child’s bone may not be able to continue growing.

With a type 5 fracture, your child’s limb can become crooked or grow to an uneven length.

Your child may have a Salter-Harris fracture if they have symptoms such as:

  • Tenderness in the area of the suspected fracture
  • Swelling in the area of the suspected fracture
  • Inability to put weight on the affected area
  • Inability to move the affected area

A Salter-Harris fracture does not necessarily cause a joint to look crooked or deformed. If your child is complaining of severe pain or pain that is not going away or is not using their joint or bearing weight on their limb, take them to the doctor.

Salter-Harris fractures are diagnosed through X-rays and an examination where your child’s doctor will ask for a complete and thorough history of your child’s health.

If your child is in a lot of pain, the doctor may also decide to get a CT scan or MRI scan to look at the injury after looking at X-rays.

Treatment depends on what type of Salter-Harris fracture your child has.‌

“Casting or splinting is the mainstay of treatment for most physeal fractures, and children typically heal quickly,” says Arun Hariharan, MD, a board-certified pediatric orthopedic surgeon with Paley Orthopedic & Spine Institute in West Palm Beach, FL.

Type 3 and 4 fractures will probably require open reduction or internal fixation. In an open reduction, a surgeon moves your bone pieces back to where they should be by cutting open your skin. Internal fixation is then used to reconnect the bone pieces using screws, nails, and wires.

Type 5 fractures are hard to diagnose, so it may take a while to figure out if your child has this kind of injury. But once you have this diagnosis, you should book an appointment for your child with an orthopedist, or bone doctor. This type of fracture is most likely to result in growth arrest, so it’s important to talk to your doctor about what can be done.

Hariharan says for minor fractures, doctors may use a cast or splint along with other treatments to aid in healing, such as:

Low-intensity pulsed ultrasound (LIPUS). Studies suggest this may help heal fractures, but more research is needed for its use in children.

Nutritional support. Children need vitamin D, calcium, and protein in order to heal, especially if they have chronic illness or low muscle tone.

Custom braces or 3D-printed splints. These are tailor made to fit your child’s body and can make them more comfortable.

If your child has a severe fracture (type 3-5), they may need surgery.

“Ultimately, the most important factor in recovery is in diagnosis, appropriate reduction, and follow-up, particularly for patients at risk for complications,” Hariharan says.

How long is the recovery time for a Salter-Harris fracture?

It depends on which bones your child injured and how badly they were broken. Most minor fractures heal in four to six weeks. More severe fractures can take longer, especially if your child needs surgery.

Most Salter-Harris fractures happen due to trauma caused by childhood accidents, such as falls, sports injuries, car accidents, or overtraining.

To keep your child from developing Salter-Harris fractures, consider the following: 

  • Encourage your child to take more breaks when participating in sports. 
  • Monitor your child’s sports training during periods of rapid growth, which is when they may be more likely to develop growth plate fractures.
  • Have your child wear proper protective gear.
  • Make sure your child warms up before sports.

You should also encourage your child to focus on developing skills rather than competing and winning. That way, your child will be less likely to get into an accident that can cause Salter-Harris fractures.

A Salter-Harris fracture is a break in the growth plate of a child’s bone. A growth plate is an area of rubbery tissue near the ends of long bones in younger children. About 1 in 3 kids will have a Salter-Harris fracture at some point, and boys are more likely to get them than girls. If caught and treated early, most of these fractures heal in about a month. Severe fractures or those that are not treated early can lead to complications and may need surgery. Once a child stops growing, their growth plates close, and they’re no longer at risk for Salter-Harris fractures.

Does a Salter-Harris fracture need a cast?

Yes, usually. Your child may need to wear a cast for four to six weeks to help keep the bone stable. If your child has a severe growth plate fracture (types 3-5), they may need surgery.

What happens if a child breaks a growth plate?

They may feel pain and tenderness near the injury or not be able to move the hurt limb. You might also notice swelling near the joint. If their injury isn’t treated right away, the fractured bone could become crooked or shorter than the other. 

At what age do growth plates close?

It varies by bone, but they usually close near the end of puberty. For girls, that’s normally around ages 13-15, and for boys, 15-17. The growth plate is closed in all bones by age 20.

What are the symptoms of a closed growth plate?

There are none. A closed growth plate just means your child has finished growing. As your child grows, the cartilage that forms their growth plate hardens and turns into solid bone.