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MINERVA ORTOPEDICA E TRAUMATOLOGICA
A Journal on Orthopedics and Traumatology
97° CONGRESS OF THE PIEDMONTESE-LIGURIAN-LOMBARD SOCIETY OF ORTHOPEDICS AND TRAUMATOLOGY (SPLLOT) - II (Alba, September 22-23, 2000)
Minerva Ortopedica e Traumatologica 2000 October;51(5):291-6
Injuries to children's feet and ankles
Valdiserri L., Poli G.
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Injuries to children's feet and ankle differ from those in adults due to the differences in the anatomical, biochemical and physiological character of infantile bone. Since infantile muscles and ligaments are far more flexible, foot fractures are rare in children who are far more likely to break a leg if they fall from a considerable height. At ankle level, the growth cartilage and ligaments are much stronger and toughter than the bone so that capsuloligamentous injuries are rare and bone fractures of a distinctive pattern. The treatment of foot fractures is generally conservative and compressionis enough to restore themp to their normal shape. However once the bone has matured and has little further potential for growth, infantile fractures have to be treated like their adult equivalents. In children up to 10 years old, Type 1 and 2 ankle fractures are generally treated conservatively, compression being enough to correct any angular defects and restore the joint to perfect shape. In other fractures, especially those involving the tibial malleolus and all Salter type III and IV fractures, where perfect reduction is essential, treatment is generally surgical. As long as the cartilage has not been irreparably damaged anatomical reduction and stabilisation of the fracture will produce satisfactory results, in the absence of which the formation of a fracture callus upstream from the metaphysis to the epiphysis will impede growth and lead to an angular defect.