The classification and prognosis of epiphyseal injuries.

Because of the difficulty of assessing prognosis, a clinical and radiological review of 103 injuries of growth plates was performed. Thirteen patients showed retardation of growth and in 4 it was clinically obvious. In addition, external deformity occurred because of failure of remodelling in 1 case. In 9 cases there appeared to be slight stimulation of growth. The correlation between the Salter-Harris classification and retardation of growth was not always clear, especially in Salter-Harris type IV injuries, wherein prognosis varied with site. At the distal end of the tibia two groups of type IV injury were identified having respectively a 0 and 62.5 per cent incidence of retardation of growth. A new classification of distal injuries of the tibia is proposed, with superior predictive value for retardation of growth than that of Salter and Harris. This is valuable as a guide to prognosis and may facilitate treatment.