Clinical Research on Foot & Ankle
Open Access

Physical ankle fractures; Pediatric skeleton; Pediatric population; Fracture patterns; Injury severity

Introduction

Mechanisms of injury and clinical presentations are explored to elucidate common causes and clinical signs, facilitating accurate diagnosis. Diagnostic evaluation utilizing imaging modalities such as X-ray, MRI, and CT scan is crucial for determining fracture type and displacement, thereby guiding treatment decisions. Treatment modalities encompass both non-operative and operative approaches, with considerations for immobilization, weight-bearing, and surgical intervention based on fracture characteristics and patient factors [1]. Complications including growth disturbances, malunion/nonunion, and neurovascular complications underscore the importance of meticulous management and long-term follow-up. Outcomes following pediatric physical ankle fractures are discussed in terms of functional recovery, return to activities, and potential for deformity correction, highlighting the significance of rehabilitation protocols tailored to pediatric patients. Prevention strategies focus on injury prevention measures and education for caregivers and children to mitigate the risk of future injuries [2,3].

Description

A pediatric physical ankle fracture refers to a fracture that involves the growth plate (physis) of the ankle bone (tibia, fibula, or both) in children and adolescents. The growth plate, also known as the epiphysical plate, is a cartilaginous region at the end of long bones where growth occurs. Due to its weaker structure compared to surrounding bone, the growth plate is particularly susceptible to injury in pediatric patients [4]. These fractures commonly occur as a result of trauma, often from sports-related activities, falls, or accidents. The mechanism of injury typically involves excessive force or torsion applied to the ankle joint, leading to disruption of the growth plate and surrounding bone. Clinical presentation of pediatric physical ankle fractures may include pain, swelling, deformity, and difficulty bearing weight on the affected limb. However, symptoms can vary depending on the severity and location of the fracture [5]. Diagnosis of pediatric physical ankle fractures usually involves a combination of clinical examination and imaging studies such as X-rays, which can reveal the presence of a fracture, its location, and degree of displacement. In some cases, additional imaging modalities such as MRI or CT scans may be necessary to further evaluate the extent of the injury [6,7].

Treatment of pediatric physical ankle fractures depends on various factors including the age of the child, the specific type and severity of the fracture, and the presence of associated injuries. Treatment options may range from non-operative measures such as immobilization with casting or bracing to surgical intervention including closed reduction and internal fixation [8]. Complications associated with pediatric physical ankle fractures may include growth disturbances, such as premature closure of the growth plate or growth arrest, which can affect the future growth and alignment of the affected limb. Other potential complications include malunion or nonunion of the fracture, joint stiffness, and neurovascular injury [9]. Long-term outcomes following pediatric physical ankle fractures can vary depending on factors such as the adequacy of initial treatment, presence of complications, and adherence to rehabilitation protocols. With appropriate management, including prompt diagnosis, tailored treatment, and comprehensive rehabilitation, most pediatric patients with physical ankle fractures can expect favorable outcomes and return to their normal activities. However, close monitoring and follow-up are essential to ensure optimal recovery and minimize the risk of complications [10].

Conclusion

In conclusion, pediatric physical ankle fractures represent a distinct subset of injuries that require careful evaluation and management due to the unique anatomical and physiological characteristics of the pediatric skeleton. These fractures commonly result from trauma and can have significant implications for growth and function if not managed appropriately. The diagnosis of pediatric physical ankle fractures relies on a combination of clinical assessment and imaging studies to accurately characterize the extent and severity of the injury. Treatment options range from non-operative measures, such as casting or bracing, to surgical intervention, depending on factors such as the age of the child, the type of fracture, and associated injuries. Complications associated with pediatric physical ankle fractures, including growth disturbances and malunion, underscore the importance of meticulous management and long-term follow-up. Rehabilitation plays a crucial role in optimizing functional recovery and minimizing the risk of longterm sequelae.

1. Abdeen AR, Collen SB, Vince KG (2010) Fifteen-year to 19-year follow-up of the Insall-Burstein-I total knee arthroplasty. J Arthroplasty. 25: 173-178.

Indexed at, Google Scholar, Crossref

2. Babis GC, Trousdale RT, Morrey BF (2002) The effectiveness of isolated tibial insert exchange in revision total knee arthroplasty. J Bone Joint Surg Am. 84: 64-68.

Indexed at, Google Scholar, Crossref

3. Bal BS, Greenberg D (2007) Failure of a metal-reinforced tibial post in total knee arthroplasty. J Arthroplasty. 22: 464-467.

Indexed at, Google Scholar, Crossref

4. Bal BS, Greenberg D, Li S, Mauerhan D, Schultz L, et al. (2008) Tibial post failures in a condylar posterior cruciate substituting total knee arthroplasty. J Arthroplasty. 23: 650-655.

Indexed at, Google Scholar, Crossref

5. Boesen MP, Jensen TT, Husted H (2004) Secondary knee instability caused by fracture of the stabilizing insert in a dual-articular total knee. J Arthroplasty. 19: 941-943.

Indexed at, Google Scholar, Crossref

6. Brooks DH, Fehring TK, Griffin WL, Mason JB, McCoy TH (2002) Polyethylene exchange only for prosthetic knee instability. Clin Orthop Relat Res. 405:182-188.

Indexed at, Google Scholar, Crossref

7. Callaghan JJ, O’Rourke MR, Goetz DD, Schmalzried TP, Campbell PA, et al. (2002) Tibial post impingement in posterior-stabilized total knee arthroplasty. Clin Orthop Relat Res. 404: 83-88.

Indexed at, Google Scholar, Crossref

8. Chiu YS, Chen WM, Huang CK, Chiang CC, Chen TH (2004) Fracture of the polyethylene tibial post in a NexGen posterior-stabilized knee prosthesis. J Arthroplasty. 19: 1045-1049.

Indexed at, Google Scholar, Crossref

9. Clarke HD, Math KR, Scuderi GR (2004) Polyethylene post failure in posterior stabilized total knee arthroplasty. J Arthroplasty. 19: 652-657.

Indexed at, Google Scholar, Crossref

10. Colizza WA, Insall JN, Scuderi GR (1995) The posterior stabilized total knee prosthesis: assessment of polyethylene damage and osteolysis after a ten-year minimum follow-up. J Bone Joint Surg Am. 77: 1713-1720.

Indexed at, Google Scholar, Crossref

11. D’Angelo F, Marcolli D, Bulgheroni P, Murena L, Congiu T, et al. (2010) Two stage fracture of a polyethylene post in a 9-year-old posterior-stabilized knee prosthesis: a case report. J Med Case Reports. 4:65.

Indexed at, Google Scholar, Crossref