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With reference to the endgames question regarding the Salter Harris
classification, we would like to point out the common mistake made with
this classification system, that unfortunately the authors of this
question have fallen into.
The epiphysis is the bony section at the end of a long bone, while
the physis is the growth plate itself.
If the fracture goes through the epiphysis with a section of
metaphysis, this is a Salter Harris 4, not a 2 as the answer suggests.
If however, the fracture goes through the physis (growth plate)
taking a piece of metaphysis, this would be a Salter Harris 2.
It is not unusual for the terms epiphysis and physis to be used
interchangeably, but we would emphasise that they are two distinct
No competing interests
15 July 2010
Fellow in Paediatric Orthopaedics
James Phillips, Consultant Orthopaedic Surgeon, Andrew Gaffey, Consultant Orthopaedic Surgeon