In this section
Distal tibia and /or fibula physeal fractures - Outpatient clinics
Subsequent review appointments
Discharge advice to parents
Isolated undisplaced distal fibula physeal - Salter-Harris type I and II
4 weeks for clinical and x-ray review. Remove cast and commence weight bearing as tolerated
Undisplaced distal tibia physeal
7 days post-ED presentation/injury with x-ray
Expect approximately 12 weeks before returning to sports. Patients will need review at 6 -9 months to assess for physeal arrest
Displaced distal tibia physeal
5 days if treated with closed reduction, 2 weeks if treated surgically
Tillaux and triplanefracture <2 mm displacement
Tillaux and triplane fracture >2 mm displacement
2 weeks post-operatively
Indications for a consultant orthopaedic surgeon opinion are:
Patients should be followed up until their fracture has healed and they have returned to normal activities. This is usually by 10-12 weeks post-injury. Patients should then be reviewed with x-ray 6 -9 months after injury to assess for growth arrest in a consultant clinic. At this point, patients can be discharged if there are no other concerns. If treated surgically, patients should be reviewed in the consultant clinic at 9 -12 months to consider need for hardware removal.
Cummings RJ, Shea KG. Distal tibial and fibular fractures. In Rockwood and Wilkins' Fractures in Children, 7th Ed. Beaty JH, Kasser JR (Eds). Lippincott Williams & Wilkins, Philadelphia 2010. p.967-1016.
Schnetzler KA, Hoernschemeyer D. The Pediatric Triplane Ankle Fracture. J Am Acad Ortho Surg 2007; 15(12): 738 -47.