A comprehensive narrative review of pediatric ankle fractures covering epidemiology, anatomy, classification, and fracture-specific treatment strategies. The paper addresses how physeal immaturity changes both fracture patterns and treatment goals compared with adult injuries, with particular focus on minimizing growth arrest.
When you see a displaced physeal ankle fracture in a child, Salter-Harris type drives your treatment decision: types I and II tolerate closed reduction and casting, but types III and IV with >2 mm residual displacement require ORIF — cutting that growth disturbance rate from 56% to 5%.
In an adolescent near skeletal maturity with an anterolateral epiphyseal fracture, think Tillaux; add a CT to confirm ≤2 mm articular step-off before committing to casting, and remember the physis can be crossed with fixation if closure is nearly complete.
A comprehensive narrative review of pediatric ankle fractures covering epidemiology, anatomy, classification, and fracture-specific treatment strategies. The paper addresses how physeal immaturity changes both fracture patterns and treatment goals compared with adult injuries, with particular focus on minimizing growth arrest.
When you see a displaced physeal ankle fracture in a child, Salter-Harris type drives your treatment decision: types I and II tolerate closed reduction and casting, but types III and IV with >2 mm residual displacement require ORIF — cutting that growth disturbance rate from 56% to 5%.
In an adolescent near skeletal maturity with an anterolateral epiphyseal fracture, think Tillaux; add a CT to confirm ≤2 mm articular step-off before committing to casting, and remember the physis can be crossed with fixation if closure is nearly complete.