Pick a classification on the left and it opens on the right. This page holds the paediatric trauma and fracture classifications. Turn on Test me to hide each answer until you tap Show answer, or press Random for a quick quiz. Each entry links to the page it comes from.
Salter-Harris (physeal fractures)
| Type I | – Through the growth plate – More common in younger patients with thicker physis – Fast healing, rare to have complications |
| Type II | – *Most common type – Through growth plate and metaphysis, spares the epiphysis – Creates a separate metaphyseal fragment, called the ‘Thurston-Holland’ fragment – Fast healing |
| Type III | – Through growth plate and epiphysis, spares the metaphysis – Creates an intra-articular fracture – Requires anatomic reduction and internal fixation |
| Type IV | – Through growth plate, epiphysis and metaphysis – Possible growth disturbance and angular deformity – Requires anatomic reduction and internal fixation |
| Type V | – Rare – Compressive injury to the growth plate (e.g. crush injuries) – No associated fractures of the epiphysis or metaphysis – Possible permanent growth arrest |
Gartland (supracondylar humerus)
| Type | Description |
|---|---|
| 1 | Undisplaced |
| 2a | Displaced with intact posterior cortex, angulation only |
| 2b | Displaced with intact posterior cortex, with rotation or translation |
| 3 | Completely displaced, no cortical contact |
Original publication Gartland JJ. Management of supracondylar fractures of the humerus in children. Surg Gynecol Obstet. 1959;109(2):145-54.
Jakob (lateral condyle)
| Stage | Description |
|---|---|
| 1 | articular surface is intact |
| 2 | into joint but no fracture fragment rotation |
| 3 | rotated & displaced |
Medial epicondyle and condyle fractures
| Type | Classification |
|---|---|
| I | Minimally displaced < 2 mm |
| II | Moderately displaced |
| III | Into joint |
| IV | Associated with a posterolateral dislocation of the elbow |
Bado (Monteggia fractures)
| Type | Description |
|---|---|
| 1 | Fracture of proximal or middle third of ulna, with anterior dislocation of radial head. Most common fracture pattern (~60%). Posterior angulation of distal ulna fragment. |
| 2 | Fracture of proximal or middle third of ulna, with posterior dislocation of the radial head. Anterior angulation of distal ulna fragment. |
| 3 | Fracture of ulna with lateral dislocation of radial head. More common in paediatric patients |
| 4 | Anterior dislocation of radial head with radial shaft fracture. |
Original publication Bado JL. The Monteggia lesion. Clin Orthop Relat Res. 1967;50:71-86.
Meyers and McKeever (tibial eminence)
| Type | Description |
|---|---|
| I | Minimally displaced |
| II | Anterior elevation with a posterior hinge, a beak on the lateral film |
| IIIA | Complete separation of the ACL insertion only |
| IIIB | Complete separation of the entire eminence |
| IV | Comminuted (Zaricznyj) |
Original publication Meyers MH, McKeever FM. Fracture of the intercondylar eminence of the tibia. J Bone Joint Surg Am. 1959;41-A(2):209-20; discussion 220-2.
Ogden (tibial tubercle)
| Type | Description |
|---|---|
| IA | Elevation of distal part of tuberosity, minor anterior separation |
| IB | Elevation of distal part of tuberosity, separated from metaphysis &/or epiphysis |
| IIA | Separation of fragment from metaphysis & remainder of epiphysis (intra-articular extension). Tuberosity separated & anteriorly angulated |
| IIB | Separation of fragment from metaphysis & remainder of epiphysis (intra-articular extension). Tuberosity separated, anteriorly angulated & fragmented |
| IIIA | Major separation of fragment with intra-articular displacement. Fragment is unitary |
| IIIB | Major separation of fragment with intra-articular displacement. Fragment is comminuted |
Original publication Ogden JA, Tross RB, Murphy MJ. Fractures of the tibial tuberosity in adolescents. J Bone Joint Surg Am. 1980;62(2):205-15.
Dias-Tachdjian (paediatric ankle)
| Supination-inversion |
| Supination plantarflexion |
| Supination-ER |
| Pronation-ER |
| Parts | Description |
|---|---|
| 2 part | Lateral & posterior epiphyseal fragment with posterior metaphyseal spike attached |
| 3 part | As described above |
| 4 part | Anterolateral & anteromedial epiphyseal fragments. Posterior epiphyseal fragment with posterior metaphyseal spike attached |
| Type | Description |
|---|---|
| Early | Acute diagnosis, about 50% of cases |
| Delayed | Onset after a latent period of 1 to 4 days |
| Recurrent | A second episode 3 days to 10 weeks later, in about 15% of cases |
Fielding and Hawkins (atlantoaxial rotatory)
| Type | Description |
|---|---|
| I | Rotatory fixation, no anterior displacement, ligament intact, most common |
| II | Anterior displacement 3 to 5 mm, one lateral mass acting as pivot |
| III | Anterior displacement more than 5 mm |
| IV | Posterior displacement |
Original publication Fielding JW, Hawkins RJ. Atlanto-axial rotatory fixation. (Fixed rotatory subluxation of the atlanto-axial joint). J Bone Joint Surg Am. 1977;59(1):37-44.
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Classification pages
Reviewed by Professor Phong Tran, Head of Orthopaedic Surgery, Western Health. Last updated 10 October 2026.