Pediatric Ankle and Foot Injuries

An understanding of the pediatric bony anatomy is necessary to guide the evaluation and treatment of children who present with injuries of the ankle and foot. All bones can be involved in a fracture, including Salter-Harris fractures of the distal tibia and fibula and a variety of foot fractures. Of special consideration are the Tillaux, Triplane, Lisfranc, Jones, and avulsion of the fifth metatarsal fractures. Treatment of each patient must be individualized and determined by fracture type, severity and displacement, and patient age. The goal of treatment is satisfactory reduction with avoidance of complications, specifically physeal damage or arrest. Follow-up with an orthopedic surgeon after the acute visit is necessary for long-term monitoring. Instructions for patients after evaluation include cast care and reasons to return to the emergency department.