A retrospective epidemiological cohort study of ankle fractures in children and teenagers.

Abstract

Background:

Ankle fracture is one of the most frequent pediatric lower-limb fractures and may result in serious complications.

Objective:

This study aimed to determine the epidemiology of ankle fractures, defining fracture types, treatments, and complications in a pediatric population below 16 years old.

Methods:

Medical records of all the ankle fracture patients treated in our hospital during 2004-2020 were retrospectively reviewed. Data regarding age, sex, mechanism of injury, fracture type, treatment modalities, and complications were collected.

Results:

We examined records involving 328 children with 331 ankle fractures, with a ratio of 1:2 male per female. Mean annual prevalence was 24.3 per 100,000 children. Mean patient age was 11.2 ± 4.2 years, with 75.3% of them aged over 10 years. Sports activities accounted for the largest percentage of fractures (162 cases; 49.4%), followed by falls (67; 20.4%) and road traffic accidents (37; 11.3%). Physeal fractures were the most frequent type of lesion (223 cases). Most ankle fractures (60%) were managed using closed reduction and casting; for the remaining 40% of cases, fracture fixation was performed after closed or open reduction to correct the articular step-off and ensure the anatomical restoration of the physis. The main ankle fracture complication was premature growth arrest (12.1% of all physeal fractures).

Conclusion:

Pediatric ankle fractures primarily affect children older than 10 years. Most of these fractures were caused by sports injuries or low-energy trauma. The majority of these fractures are physeal, and the distal tibial physis is affected 10 times more frequently than the distal fibular physis.

Level of evidence:

Level III.

• Authors: Christina Steiger, Giacomo De Marco, Céline Cuérel, Anne Tabard-Fougère, Moez Chargui, Romain Dayer, Dimitri Ceroni
• Journal: Journal of children's orthopaedics (J Child Orthop) Vol. 17 Issue 4 Pg. 348-353 (Aug 2023) ISSN: 1863-2521 [Print] England
• PMID: 37565007 (Publication Type: Journal Article)
• Copyright: © The Author(s) 2023.