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Pediatric and Adolescent Ankle Fractures: Current Concepts and Advances in Management

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Journal of Clinical Orthopaedics | Vol 9 | Issue 2 |  July-December 2024 | page: 44-46 | Swapnil M. Keny

DOI: https://doi.org/10.13107/jcorth.2024.v09i02.660

Open Access License: CC BY-NC 4.0

Copyright Statement: Copyright © 2024; The Author(s).

Submitted Date: 25 Aug 2024, Review Date: 12 Sep 2024, Accepted Date: 16 Sep 2024 & Published Date: 10 Dec 2024

Author: Swapnil M. Keny [1, 2, 3]

[1] Department of Orthopaedics, K. B. Bhabha Hospital, Bandra, Mumbai, Maharashtra, India,
[2] Department of Orthopaedics, Sir H. N. Reliance Hospital, Mumbai, Maharashtra, India
[3] Department of Orthopaedics, Apollo Hospital, Navi Mumbai, Maharashtra, India.

Address of Correspondence

Dr. Swapnil M. Keny,
Consultant Pediatric Orthopaedic Surgeon, K. B. Bhabha Hospital, Mumbai, Sir H. N. Reliance Hospital, Mumbai, Apollo Hospital, Navi Mumbai, Maharashtra, India.
E-mail: peadortho@gmail.com

Abstract

Pediatric and adolescent ankle fractures are frequently encountered injuries, often involving the distal tibial growth plate and requiring special management due to the potential for growth disturbances. Recent developments in imaging, surgical techniques, and rehabilitation have significantly improved outcomes. This review highlights contemporary practices in the diagnosis and treatment of ankle fractures in younger patients, with a focus on advances in diagnostic tools, operative management, and individualized care. It also explores the integration of new technologies, such as 3D printing and artificial intelligence, in fracture planning and management, reflecting the current standard of care.
Keywords: Pediatric, ankle fractures, distal tibial physeal injuries, Salter-Harris injuries, internal fixation, decision making.

References

1. Liporace FA, Yoon RS, Kubiak EN, Parisi DM, Koval KJ, Feldman DS, et al. Does adding computed tomography change the diagnosis and treatment of Tillaux and triplane pediatric ankle fractures? Orthopedics 2012;35:e208-12.
2. Eismann EA, Stephan ZA, Mehlman CT, Denning J, Mehlman T, Parikh SN, et al. Pediatric triplane ankle fractures: Impact of radiographs and computed tomography on fracture classification and treatment planning. J Bone Joint Surg Am 2015;97:995-1002.
3. Nenopoulos A, Beslikas T, Gigis I, Sayegh F, Christoforidis I, Hatzokos I, et al. The role of CT in diagnosis and treatment of distal tibial fractures with intra-articular involvement in children. Injury 2015;46:2177-80.
4. Seifert J, Matthes G, Hinz P, Paris S, Mutze S, Ekkernkamp A, et al. Role of magnetic resonance imaging in the diagnosis of distal tibia fractures in adolescents. J Pediatr Orthop 2003;23:727.
5. Salter RB, Harris WR. Injuries involving the epiphyseal plate. J Bone Joint Surg Am 1963;45:587-622.
6. Cooperman DR, Spiegel PG, Laros GS. Tibial fractures involving the ankle in children. The so-called triplane epiphyseal fracture. J Bone Joint Surg Am 1978;60:1040-6.
7. Spiegel PG, Cooperman DR, Laros GS. Epiphyseal fractures of the distal ends of the tibia and fibula: A retrospective study of two hundred and thirty-seven cases in children. J Bone Joint Surg Am 1978;60:1046-50.
8. Cass JR, Peterson HA. Salter-Harris type-IV injuries of the distal tibial epiphyseal growth plate, with emphasis on those involving the medial malleolus. J Bone Joint Surg Am 1983;65:1059-70.
9. Cummings RJ, Shea KG. Distal tibial and fibular fractures. In: Beaty JH, Kasser JR, editors. Rockwood and Wilkins’ Fractures in Children. 7th ed. Philadelphia, PA: Lippincott Williams and Wilkins; 2010.
10. Asad WA, Younis MH, Ahmed AF, Ibrahim T. Open versus closed treatment of distal tibia physeal fractures: A systematic review and meta-analysis. Eur J Orthop Surg Traumatol 2017;27:503-9.

How to Cite this article: Keny SM. Pediatric and Adolescent Ankle Fractures: Current Concepts and Advances in Management. Journal of Clinical Orthopaedics July-December 2024;9(2):44-46.

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Sagittal and Coronal Plane Fracture of Talar Body, An Unusual Combination with Medial Malleolus Fracture: A Case Report

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Journal of Clinical Orthopaedics | Vol 6 | Issue 2 |  Jul-Dec 2021 | page: 52-55 | Pankaj Kumar Singh, Surendra Kumar Shukla, Satish Chandra Goel, Sachin Yashwant Kale, Rohit Mahesh Sane

Author: Pankaj Kumar Singh [1], Surendra Kumar Shukla [2], Satish Chandra Goel [1], Sachin
Yashwant Kale [3], Rohit Mahesh Sane [3]

[1] Department of Orthopaedics, Heritage Institute of Medical Sciences, Varanasi, Uttar Pradesh, India.

[2] Department of Orthopaedics, K.J. Somaiya Medical College, Sion, Mumbai, Maharashtra, India.

[3] Department of Orthopaedics, D.Y. Patil University School of Medicine, Nerul, Navi-Mumbai, Maharashtra, India.

Address of Correspondence
Dr. Rohit Mahesh Sane,
Department of Orthopaedics, D.Y. Patil University School of Medicine, Nerul, Navi-Mumbai, Maharashtra, India.
E-mail: dr.sanerohit@gmail.com

Abstract

Introduction: Fractures of the talus are relatively uncommon injuries with majority of them involving the neck region. Talar body fracture in sagittal plane in combination with medial malleolus fracture is very rare with few cases being reported in the literature earlier.

Aims and Objectives: To discuss such an unusual combination in an adolescent, which was treated with open reduction and internal fixation with screws for both talus and medial malleolus.

Materials and Methods: A 18-year-old boy with medial malleolus and sagittal plane talus fracture was treated with open reduction and internal fixation.

Conclusion: Talar body fractures in the sagittal plane and its combination with medial malleolus fracture are challenging due to its rarity and associated high degree of complications. Surgery should be planned at appropriate time considering the status of surrounding soft tissues and swelling. Proper anatomic reduction and rigid fixation with good surgical technique followed by cast immobilization and non-weight bearing for longer periods (at least 3 months or till radiological union) is the key to a good clinical outcome.

Keywords: Fracture, Talar body, Sagittal plane, Medial malleolus, Internal fixation

References

1. Fortin PT, Balazsy JE. Talus fractures: Evaluation and treatment. J Am Acad Orthop Surg 2001;9:114.
2. Hawkins LG. Fractures of the neck of the talus. J Bone Joint Surg 1970;52A:991-1002.
3. Adelaar RS. Fractures of the talus. In: Operative Foot Book. Philadelphia, PA: WB Saunders; 1990. p. 147-56.
4. Mendonca AD, Maury AC, Makwana NK. A simultaneous fracture of the tibia and talar body. Foot Ankle Surg 2004;10:45-7.
5. Shah K, Hakmi A. Unusual ankle injury a case report. Foot 2004;14:169-72.
6. Devalia KL, Ismaiel AH, Joseph G, Jesry MG. Fourteen years follow up of an unclassified talar body fracture with review of literature. Foot Ankle Surg 2006;12:85-8.
7. Saidi H, Ayach A, Fikry T. Unusual fracture of the body of the talus: a case report and literature review. Foot Medicine and Surgery 2008;24:22-4.
8. Isaacs J, Courtenay B, Cooke A, Gupta M. Open reduction and internal fixation forconcomitant talar neck, talar body, and medial malleolar fractures: A case report. J Orthop Surg 2009;17:112-5.
9. Mootha A, Kumar V, Bali K, Dhatt S, Aggarwal S. Combined talar body and medial malleolus fracture: A case report. Webmed Central Orthop 2010;1:WMC00952.
10. Mechchat A, Bensaad S, Mohammed S, Elibrahimi A, Elmrini A. Unusual ankle fracture: A case report and literature review. J Clin Orthop Trauma 2014;5:103-6.
11. Vallier HA, Nork SE, Benirschke SK, Sangeorzan BJ. Surgical treatment of talar body fractures. J Bone Joint Surg Am 2003;85:1716-24.
12. Ogawa K, Usami N. Classification of fractures of the talus: Clear differentiation between neck and body fractures. Foot Ankle Int 1996;17:748-50.
13. Sneppen O, Christensen SB, Krogsoe O, Lorentzen J. Fracture of the body of the talus. Acta Orthop Scand 1977;48:317-24.
14. Boyd HB, Knight RA. Fractures of the astragalus. South Med J 1942;35:160-7.
15. Arkesh M, Gaba S, Das S, Palanisamy JV, Trikha V. A rare combination of sagittal plane fracture of talar body with medial malleolus fracture: Case report and review of literature. J Clin Orthop Trauma 2016;7 Suppl 1:30-4.

How to Cite this article: Singh PK, Shukla SK, Goel SC, Kale SY, Sane RM. Sagittal and Coronal Plane Fracture of Talar Body, An Unusual Combination with Medial Malleolus Fracture: A Case Report.. Journal of Clinical Orthopaedics Jul-Dec 2021;6(2):52-55.

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