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James W.A. Fletcher Department for Health, University of Bath, UK
AO Research Institute Davos, Switzerland

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Lisa Wenzel AO Research Institute Davos, Switzerland
Department of Trauma Surgery, Trauma Center Murnau, Germany

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Verena Neumann AO Research Institute Davos, Switzerland

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R. Geoff Richards AO Research Institute Davos, Switzerland

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Boyko Gueorguiev AO Research Institute Davos, Switzerland

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Harinderjit S. Gill Department of Mechanical Engineering, University of Bath, UK

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Ezio Preatoni Department for Health, University of Bath, UK

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Michael R. Whitehouse Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, Southmead Hospital, Bristol, UK
National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, UK

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outside the submitted work. RGR reports support for travel to meetings for the study or other purposes from AO Research Institute Davos for the submitted work. HSG reports a grant covering first author from the Royal College of Surgeons for the

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Benjamín Cancino Universidad Austral de Chile, Valdivia, Chile

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Matías Sepúlveda Universidad Austral de Chile, Valdivia, Chile
Hospital Base de Valdivia, Valdivia, Chile

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Estefanía Birrer Hospital Base de Valdivia, Valdivia, Chile
Universidad Austral de Chile, Valdivia, Chile

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  • Ankle fractures are common in children, and they have specific implications in that patient population due to frequent involvement of the physis in a bone that has growth potential and unique biomechanical properties.

  • Characteristic patterns are typically evident in relation to the state of osseous development of the segment, and to an extent these are age-dependent.

  • In a specific type known as transitional fractures – which occur in children who are progressing to a mature skeleton –a partial physeal closure is evident, which produces multiplanar fracture patterns.

  • Computed tomography should be routine in injuries with joint involvement, both to assess the level of displacement and to facilitate informed surgical planning.

  • The therapeutic objectives should be to achieve an adequate functional axis of the ankle without articular gaps, and to protect the physis in order to avoid growth alterations.

  • Conservative management can be utilized for non-displaced fractures in conjunction with strict radiological monitoring, but surgery should be considered for fractures involving substantial physeal or joint displacement, in order to achieve the therapeutic goals.

Cite this article: EFORT Open Rev 2021;6:593-606. DOI: 10.1302/2058-5241.6.200042

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Pierre J. Hoffmeyer Editor-in-Chief, EFORT Open Reviews

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” awarded the Swiss Orthopaedic Society’s Debrunner Prize. Having been active in the AO Foundation since the seventies, Daniel was a precursor and proponent of non-operative functional treatment which he successfully applied to tibial fractures of skiers

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Alfonso Vaquero-Picado Department of Orthopaedic Surgery, Hospital Universitario La Paz, Spain

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Gaspar González-Morán Department of Orthopaedic Surgery, Hospital Universitario La Paz, Spain

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Luis Moraleda Department of Orthopaedic Surgery, Hospital Universitario La Paz, Spain

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Kay RM Leitch K . Effect of surgical delay on perioperative complications and need for open reduction in supracondylar humerus fractures in children . J Pediatr Orthop 2004 ; 24 ( 3 ): 245 - 248 . 38. Yildirim AO

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