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

Pediatric ankle fracture epidemiologic low-energy trauma sports injuries

Journal

Journal of children's orthopaedics
ISSN: 1863-2521
Titre abrégé: J Child Orthop
Pays: England
ID NLM: 101313582

Informations de publication

Date de publication:
Aug 2023
Historique:
received: 04 01 2023
accepted: 15 05 2023
medline: 11 8 2023
pubmed: 11 8 2023
entrez: 11 8 2023
Statut: epublish

Résumé

Ankle fracture is one of the most frequent pediatric lower-limb fractures and may result in serious complications. This study aimed to determine the epidemiology of ankle fractures, defining fracture types, treatments, and complications in a pediatric population below 16 years old. 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. 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). 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 III.

Sections du résumé

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

Identifiants

pubmed: 37565007
doi: 10.1177/18632521231182424
pii: 10.1177_18632521231182424
pmc: PMC10411379
doi:

Types de publication

Journal Article

Langues

eng

Pagination

348-353

Informations de copyright

© The Author(s) 2023.

Déclaration de conflit d'intérêts

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Références

Injury. 2008 Oct;39(10):1222-7
pubmed: 18538772
Acta Orthop Scand. 1967;38(4):520-31
pubmed: 4970201
J Pediatr Surg. 2013 Jun;48(6):1384-8
pubmed: 23845634
Tidsskr Nor Laegeforen. 1998 Sep 20;118(22):3415-8
pubmed: 9800490
J Bone Joint Surg Am. 1984 Jun;66(5):647-57
pubmed: 6725313
J Bone Joint Surg Am. 1978 Dec;60(8):1046-50
pubmed: 721852
Acta Orthop Scand. 1983 Aug;54(4):634-40
pubmed: 6422694
J Pediatr Orthop. 2005 Jul-Aug;25(4):518-22
pubmed: 15958907
J Pediatr Orthop. 1987 Sep-Oct;7(5):518-23
pubmed: 3497947
J Pediatr Orthop. 2011 Jan-Feb;31(1):11-6
pubmed: 21150726
J Pediatr Orthop. 2012 Jun;32 Suppl 1:S69-73
pubmed: 22588107
J Orthop Trauma. 1993;7(1):15-22
pubmed: 8433194
J Pediatr Orthop. 2006 May-Jun;26(3):322-8
pubmed: 16670543
J Pediatr Orthop. 1994 Jul-Aug;14(4):423-30
pubmed: 8077422
J Bone Miner Res. 2004 Dec;19(12):1976-81
pubmed: 15537440
Injury. 1993 Apr;24(4):247-8
pubmed: 8325682
J Pediatr Orthop. 1992 Jul-Aug;12(4):499-502
pubmed: 1613095
Pediatrics. 2007 Jun;119(6):e1256-63
pubmed: 17545357
J Bone Miner Res. 2003 Nov;18(11):1970-7
pubmed: 14606509
Am J Sports Med. 1978 Sep-Oct;6(5):263-8
pubmed: 707686
J Bone Joint Surg Am. 1983 Oct;65(8):1059-70
pubmed: 6630250
J Pediatr Orthop. 2009 Jun;29(4):356-61
pubmed: 19461377
J Pediatr Orthop. 1986 Jan-Feb;6(1):47-50
pubmed: 3941180
J Pediatr Orthop. 2013 Jul-Aug;33(5):524-9
pubmed: 23752150
J Pediatr Orthop. 2003 Nov-Dec;23(6):733-9
pubmed: 14581776
Eur J Emerg Med. 2004 Jun;11(3):148-50
pubmed: 15167174
J Bone Joint Surg Am. 1999 Apr;81(4):500-9
pubmed: 10225795
J Trauma. 1972 Apr;12(4):275-81
pubmed: 5018408
J Pediatr Orthop B. 1997 Apr;6(2):79-83
pubmed: 9165435

Auteurs

Christina Steiger (C)

Pediatric Orthopedics Unit, Pediatric Surgery Service, Department of Women, Child, and Adolescent, University Hospitals of Geneva, Geneva, Switzerland.

Giacomo De Marco (G)

Pediatric Orthopedics Unit, Pediatric Surgery Service, Department of Women, Child, and Adolescent, University Hospitals of Geneva, Geneva, Switzerland.

Céline Cuérel (C)

Pediatric Orthopedics Unit, Pediatric Surgery Service, Department of Women, Child, and Adolescent, University Hospitals of Geneva, Geneva, Switzerland.

Anne Tabard-Fougère (A)

Pediatric Orthopedics Unit, Pediatric Surgery Service, Department of Women, Child, and Adolescent, University Hospitals of Geneva, Geneva, Switzerland.

Moez Chargui (M)

Pediatric Orthopedics Unit, Pediatric Surgery Service, Department of Women, Child, and Adolescent, University Hospitals of Geneva, Geneva, Switzerland.

Romain Dayer (R)

Pediatric Orthopedics Unit, Pediatric Surgery Service, Department of Women, Child, and Adolescent, University Hospitals of Geneva, Geneva, Switzerland.

Dimitri Ceroni (D)

Pediatric Orthopedics Unit, Pediatric Surgery Service, Department of Women, Child, and Adolescent, University Hospitals of Geneva, Geneva, Switzerland.

Classifications MeSH