Tipo III.
En estas fracturas, parte del trayecto también es una separación fisaria pura pero, en un punto determinado, se produce una inflexión y cruza la fisis y la epífisis hasta llegar a la superficie articular. Están producidas por un mecanismo de cizallamiento intraarticular.
Tipo IV.
En este tipo, la línea de fractura comienza en la superficie articular y atraviesa, casi perpendicularmente, la epífisis, la fisis y la metáfisis.
Suelen ser consecuencia de fuerzas de avulsión o cizallamiento.
La gravedad las fracturas tipos III y IV estriba en dos puntos: el trayecto es intraarticular y la comunicación epifiso-metafisaria que se produce hace posible la formación de puentes óseos.
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