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Paediatric Ankle & Foot Fractures

Ankle Fractures

  • Supination Eversion
    • SH III or IV of the medial malleolus & SH I of the fibula
  • Pronation External Rotation
    • Lateral Thorston Holland fragment – with SH II of the tibia
    • Fracture is above the fibular growth plate

Epiphyseal Injury

  • SH I of  Fibula – cast
  • SH II of tibia – closed reduction & cast
  • ORIF if joint signigicantly displaced

Transitional Fractures

  • Growth stops central & then moves medial & then circumferential to end at anterolateral

Tillaux

  • Avulsion of the lateral distal tibial epiphysis by the syndesmosis
  • Closed reduction & casting

Triplane

  • Secondary to external rotation
    • Two part – one intraarticular & one extrarticular
    • Three part – the Tillaux fragment is a separate piece
    • Four part
  • Consider a CT scan
  • AP SH III
  • Lat SH II
  • ORIF if  joint displaced greater than 2 mm

 

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