Limits...
Unusual fracture combination in a paediatric acute ankle (combined medial talar compression fracture with medial malleolus fracture in an immature skeleton): a case report.

Crosswell S, Rhee SJ, Wagner WW - J Surg Case Rep (2014)

Bottom Line: We present a case report of a skeletally immature 15-year-old Caucasian male who sustained a medial malleolar and corresponding medial talus fracture after being ejected from his pushbike.Through this case, we aim to highlight the need for having high suspicions of underlying fractures in paediatric trauma cases.The long-term complications and risks of osteonecrosis of the talus can have detrimental effect on a patient's outcome; therefore, we also emphasize the need for regular monitoring and long-term follow-up.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Trauma and Orthopaedics, The Shrewsbury and Telford Hospital NHS Trust, Princess Royal Hospital, Telford, Shropshire, UK sebastien.crosswell@doctors.org.uk.

No MeSH data available.


Related in: MedlinePlus

Right ankle CT axial view demonstrates undisplaced compression fracture of the medial body of the talus.
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4197413&req=5

RJU100F3: Right ankle CT axial view demonstrates undisplaced compression fracture of the medial body of the talus.

Mentions: The patient subsequently underwent a manipulation under anaesthesia and POP application of his left distal tibia and right ankle to correct the talar displacement. Despite this, post-operative radiographs of the right ankle showed persistent widened medial tibio-talar joint, and the patient developed considerable right ankle pain and soft tissue swelling which did not correspond with the initial radiograph findings. Magnetic resonance imaging (MRI) of the right ankle joint was performed which revealed extensive marrow oedema through the medial malleolus epiphysis and the medial body of the talus. There was evidence of disruption of the medial cortex of the talus which explained the widened medial tibio-talar joint (Fig. 2). No disruptions of the epiphyseal plates or ligamentous structures were identified. The injury around the tibio-talar joint was identified as an undisplaced fracture through the postero-medial talus with a corresponding ‘kissing’-type lesion of the inner surface of the medial malleolus with gross soft tissue oedema. In view of the overlooked skeletal injury, a further computer tomography (CT) scan of the ankle joint was performed which confirmed a fragmented undisplaced fracture of the postero-medial aspect of the talus, with the anterior subtalar joint remaining intact and an undisplaced fracture through the medial malleolus (Fig. 3).Figure 2:


Unusual fracture combination in a paediatric acute ankle (combined medial talar compression fracture with medial malleolus fracture in an immature skeleton): a case report.

Crosswell S, Rhee SJ, Wagner WW - J Surg Case Rep (2014)

Right ankle CT axial view demonstrates undisplaced compression fracture of the medial body of the talus.
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4197413&req=5

RJU100F3: Right ankle CT axial view demonstrates undisplaced compression fracture of the medial body of the talus.
Mentions: The patient subsequently underwent a manipulation under anaesthesia and POP application of his left distal tibia and right ankle to correct the talar displacement. Despite this, post-operative radiographs of the right ankle showed persistent widened medial tibio-talar joint, and the patient developed considerable right ankle pain and soft tissue swelling which did not correspond with the initial radiograph findings. Magnetic resonance imaging (MRI) of the right ankle joint was performed which revealed extensive marrow oedema through the medial malleolus epiphysis and the medial body of the talus. There was evidence of disruption of the medial cortex of the talus which explained the widened medial tibio-talar joint (Fig. 2). No disruptions of the epiphyseal plates or ligamentous structures were identified. The injury around the tibio-talar joint was identified as an undisplaced fracture through the postero-medial talus with a corresponding ‘kissing’-type lesion of the inner surface of the medial malleolus with gross soft tissue oedema. In view of the overlooked skeletal injury, a further computer tomography (CT) scan of the ankle joint was performed which confirmed a fragmented undisplaced fracture of the postero-medial aspect of the talus, with the anterior subtalar joint remaining intact and an undisplaced fracture through the medial malleolus (Fig. 3).Figure 2:

Bottom Line: We present a case report of a skeletally immature 15-year-old Caucasian male who sustained a medial malleolar and corresponding medial talus fracture after being ejected from his pushbike.Through this case, we aim to highlight the need for having high suspicions of underlying fractures in paediatric trauma cases.The long-term complications and risks of osteonecrosis of the talus can have detrimental effect on a patient's outcome; therefore, we also emphasize the need for regular monitoring and long-term follow-up.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Trauma and Orthopaedics, The Shrewsbury and Telford Hospital NHS Trust, Princess Royal Hospital, Telford, Shropshire, UK sebastien.crosswell@doctors.org.uk.

No MeSH data available.


Related in: MedlinePlus