A Clinical Study of the Children's Ankle Fractures with Growth Plate Injury

Chung, Yung Khee; Lee, Kee Byoung; Chung, Nam Hwa

Abstract

The fractures of the ankle in children are differ from those of adults in terms of the fracture pattern and the possibilities of influence to growth. The injuries of the ankle in children occur mostly at the bony structure rather than ligamentous structure, and some injuries of the growth plate may result in the arrest of entire growth plate or parts of growth plate and these may lead to leg length discrepancy or deformity. Many authors agree that the prognosis of injuries of the growth plate is dependent on the fracture type, the age of the patient at the onset of injuries, the degree of displacement of the fracture fragments, whether the injuries open or closed, and the efficacy of reduction. But the authors can not postulate one uniformed method of classification and treatment of the children's ankle fracture because of the variability of injuries. We have reviewed 35 cases of children's ankle fracture treated at our clinics from Dec. 1979 to Feb. 1984. The results obtained are as follows: l. Over half of the patients were between the ages of 13 and 16 years (54.3%). 2. The incidence of each type as Salter-Harris classification was that of type II(48.6%), type I(20.0%),type III(14.3%),type IV (8.6%). 3. The traffic accidents were the main causes of injury (68.5%). 4. The type I fractures occured mostly under 10 years of age and the type II fractures in adolescents. 5. All the type I fractures were treated conservatively without any complication, and the type II fractures were treated conservatively in 13 cases (76.5%) and operatively in 4 cases (23.5%) with variable results. 6. Overall incidence of complication was 20.0%, consisted with two cases of conservatively treated but not accurately reduced type II fractures, a conservatively treated type III fracture, a triplane fracture, and the others.