Understanding the Salter-Harris classification of physeal fractures is essential for predicting growth-arrest risk in children. By tracking where the fracture line travels relative to the growth plate, orthopaedic surgeons can determine the threat to the germinal layer and commit to the correct operative plan. ⏱ Chapters 0:00 Intro 0:36 Foundations 1:04 Physeal architecture 1:55 SALTR — Fracture Exit Direction 2:31 Epidemiology 3:08 Recognising It 3:58 Radiograph · Type II 4:33 Radiograph · Type III 5:14 Transitional fractures 5:53 Managing It 6:35 Pitfalls 7:08 Operative Concepts 7:49 Recap & sources This video provides a comprehensive guide to the Salter-Harris classification system, exploring the anatomy of the physis and explaining why the fracture line's path dictates clinical outcomes. We cover the SALTR mnemonic (Types I-V), the importance of the Thurston-Holland fragment, and the Peterson modification, all while explaining how high-risk patterns and anatomical sites like the distal femur dictate the need for anatomic reduction and prolonged monitoring. 🦴 IN THIS VIDEO YOU'LL LEARN • How the fracture line's path through the physis, epiphysis, and metaphysis predicts the risk of growth arrest • The anatomical layers of the growth plate and why the hypertrophic zone is the weakest link • How to accurately apply the SALTR mnemonic to classify physeal injuries • Why the Thurston-Holland fragment is the radiographic hallmark of a Type II fracture • The management principles for intra-articular fractures requiring anatomic reduction • Why the distal femur carries a high risk of growth disturbance regardless of the fracture type • The role of CT and MRI in evaluating articular step-off and occult Type V crush injuries • How to safely apply physis-sparing fixation when treating unstable physeal fractures • How to monitor for manage late complications such as a physeal bar 📌 KEY TAKEAWAYS ✔️ The higher the Salter-Harris type number, the higher the risk of physeal growth disturbance. ✔️ Types III and IV are intra-articular fractures that demand anatomic open reduction to prevent post-traumatic arthritis. ✔️ Anatomical site matters as much as fracture type, with distal femoral physeal fractures causing growth disturbance in over half of cases. ✔️ Type V is a crush injury that is often diagnosed retrospectively after asymmetric growth appears. ✔️ Place fixation hardware parallel to the physis, as transphyseal threaded hardware can create an iatrogenic growth bar. ✔️ Monitor high-risk physeal fractures with serial radiographs for 12 to 18 months to detect early physeal bar formation. 👩⚕️ WHO THIS IS FOR This video is designed for orthopaedic trainees, medical students, and treating clinicians seeking a clear, systematic understanding of paediatric fracture management. Curious patients and caregivers looking to understand the prognosis and surgical decisions surrounding childhood growth plate injuries will also find it highly informative. 📚 RELATED TOPICS: Peterson classification of physeal fractures · Management of distal femoral physeal fractures · Langenskiöld procedure for physeal bar resection · Paediatric distal tibia and triplane fractures · Park-Harris growth arrest lines · Epiphysiodesis techniques for limb-length discrepancy 🔗 More free orthopaedic teaching at Orthovellum.com — subscribe for weekly videos. 🎨 CREDITS • Original Orthovellum production. ⚠️ DISCLAIMER: Educational only — not individual medical advice. Always consult a qualified clinician for diagnosis and treatment. #orthopaedics #paediatricorthopaedics #salterharris #fractureclassification #growthplate #physis #paediatricfractures #orthopedicsurgery #traumaorthopedics #medicaleducation #fracturefixation #bonGrowth #pediatricortho #orthoteaching