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Paediatric Ankle Fractures: Guidelines to Management.

K Venkatadass1, G Sangeet1, V Durga Prasad1

  • 1Department of Orthopaedics and Spine Surgery, Ganga Hospital, 313, Mettupalayam Main Road, Coimbatore, Tamilnadu India.

Indian Journal of Orthopaedics
|February 11, 2021
PubMed
Summary

Paediatric ankle fractures are common physeal injuries. Management guidelines emphasize CT scans for suspected fractures and anatomical reduction for displaced intra-articular injuries to prevent premature physeal closure.

Keywords:
AnkleFractureInjuryPaediatricPhysealTreatment

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Area of Science:

  • Orthopaedic surgery
  • Paediatric trauma

Background:

  • Paediatric ankle fractures constitute 5% of all paediatric fractures and 15-20% of lower limb physeal injuries.
  • This review addresses management controversies and provides evidence-based guidelines for these common injuries.

Purpose of the Study:

  • To review current literature on paediatric ankle fractures.
  • To provide management guidelines based on evidence and clinical experience.

Main Methods:

  • Literature review focusing on Salter-Harris classification and transitional fractures (biplane, triplane).
  • Emphasis on imaging modalities and surgical reduction techniques.

Main Results:

  • Low threshold for CT scan in suspected fractures or intra-articular involvement, especially in adolescents.
  • CT aids in quantifying displacement and understanding fracture geometry.
  • Displaced intra-articular fractures (>2 mm) require anatomical reduction and stabilization.
  • Closed reduction with percutaneous fixation and arthrogram is acceptable if reduction is perfect.

Conclusions:

  • Accurate diagnosis with CT is crucial for displaced intra-articular paediatric ankle fractures.
  • Anatomical reduction and stable fixation are key to successful outcomes.
  • Counseling on premature physeal closure and regular follow-up are essential for children with significant growth potential.