Ankle Fracture in Children: Complication and Its Management

Kim, Hui Taek; Kim, Sang Wook; Suh, Jeung Tak; Yoo, Chong Il

Abstract

Ankle fractures in children often involve the physis. They are of particular importance because partial or entire growth arrest can occur and result in significant complications. We followed thirty-four ankle fracture involving distal physis of tibia and fibula for more than 1 year and analyzed them using the modified Salter-Harris classification, the Dias-Tachdjian classification and the type of fracture (closed or open), Complications occurred in eight cases (23.5%) - two of twenty-six closed fractures (7.7%) and six of eight open fractures (75%). The complications were more significant in open fractures. Angular deformity (5 cases), limb-length discrepancy (4 cases), incongruity of the joint surface (2 cases), fibular overgrowth (2 cases) and synostosis (1 case) occurred alond or combined. In three cases of them we performed surgical management (bone bridge resection or/and supramalleolar corrective osteotomy) and had satisfactory results. This study suggests that the incidence of complications is difficult to anticipate, but is correlated with severity of initial injuries of growth plate and soft tissue, and is much higher in open fracture. After physeal injury, children should be followed until skeletal maturity and the severe deformities can be prevented by early detection and correction of growth plate disturbance.