On lateral x-ray view, fracture line will be seen above the growth plate. A possible explanation of substantial bias is the obliqueness of the fracture line to the X-ray beam 10, 33. If child is NOT weight bearing x-ray ankle to check for fractures. In addition, patients may not cooperate because of pain and swelling of the ankle in the acute injury. CTĬomplex metaphyseal or epiphyseal fractures can be further assessed at CT. Due to the diversity of fracture lines of posterior malleolus, we doubt if one lateral view can satisfy all situations. If the fracture is completely within the physis, there is no bony abnormality and there may just be widening or narrowing of the physis which can be challenging to diagnose at the initial presentation. X-rays are usually all that is required to make the diagnosis. Fibular fractures often occur 2-6 cm proximal to the distal lateral malleolus 2. When the fracture passes towards the epiphysis, it passes through the zones of proliferation and reserve which result in possible premature closure of the growth plate at the fracture site. Fractures of the lateral and medial malleolus are common in soccer and basketball players. Fortunately, this is not a region of active growth, and therefore fractures through this area have a good prognosis. Fractures tend to propagate along the weakest zone, which is the spongiosum. Sometimes it can be a radiologist who missed an ankle fracture they should have seen in radiology studies like an X-Ray. ![]() This bone is part of the fibula, one of two bones of the lower leg. The growth plate has five distinctive zones. Lateral malleolus fracture a break of the lateral malleolus, the bone on the outside of the ankle joint. Physeal fractures are most common in 10-to-16-year-old children, except for elbow fractures, which are more common in 3-to-6-year-old children 2. They most commonly occur following trauma, although at the hip, a slipped upper femoral epiphysis (SUFE) is a type I fracture that can occur without an acute traumatic event. Physeal fractures represent ~35% of all skeletal injuries in children 2. Physeal fractures are also commonly called Salter-Harris fractures because the dominant and ubiquitous classification for these injuries is the Salter-Harris classification.
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