[Ankle fractures in children]

In the present work we address the issue of rare childhood bone fractures of the talus. In the study, we retrospectively analyzed a group of pediatric patients with fractures of the talus treated in the space of 10 years at two workplaces of trauma surgery. Patients were evaluated clinically and radiographically with at least one year follow-up. Fourteen patients with a mean age of 12 years met the methodological criteria. All suffered low-energy trauma. According to Marti-Weber classification six of them suffered central fracture of the talus. Of these, two were treated by closed reduction and internal fixation. The other patients were treated conservatively. In one patient we observed the presence of Hawkins' sign. We observed only minor complications in patients with peripheral fractures of the talus. Hawkins' overall average score of our patients was 15 points. The discussion is a comparison of some aspects of fractures of the talus in children and adults. We also note the discrepancies in the conclusions of several authors dealing with the issue of pediatric talar fractures. We specialize in central talus fractures, mechanisms of their origin, their optimal treatment and the issue of factors affecting the emergence of avascular necrosis of the talus. The absence of serious complications in our series of patients may be due to their low numbers, early definitive treatment, or the nature of their fractures. Good therapeutic results may be also due to the lower tendency for developing complications after talar fractures in pediatric patients. In the absence of relevant data in the literature we can accept with certainty only that fracture of the talus in a child should not be overlooked and should be treated according to principles that adhere to the treatment of fractures of the talus in adults, followed by long-term dispensary.