Ankle fractures in children and adolescents

Ankle fractures occur frequently in the pediatric population with the distal tibia and fibula representing one of the most common sites for physeal injury. A clinician must hold a high index of suspicion for a possible physeal fracture in children versus a simple sprain/strain as in adults. In addition, a thorough understanding of injury type is critical to reduce possible short and long-term complications. The goals of care include achieving and maintaining anatomic reduction and preventing growth arrest, which may cause angular deformity or leg-length discrepancy. Anatomic reduction of intra-articular fractures should be achieved to minimize premature arthritis from articular incongruity. If recognized quickly and treated appropriately, the majority of pediatric ankle fractures have a good prognosis with few long-term sequelae.