Degenerative Changes and Functional Evaluation of Intraarticular Ankle Fractures in Pediatric Patients
DOI:
https://doi.org/10.1016/j.rccot.2020.04.005Keywords:
articular ankle fractures, degenerative changes, pediatrics, evidence level: IIIAbstract
Background: Ankle fractures represent 12% of fractures in pediatric age. We hypothesized that patients with intra-articular ankle fractures will have an excellent functional result and will not present degenerative joint changes 6 months after surgery. The objective of the study is to carry out an analysis of the functional result, as well as the presence of early degenerative radiological changes in the follow-up of patients with intra-articular ankle fractures treated in our center.
Methods: Retrospective cohort study, data were collected from patients with intra-articular ankle fractures between 2012 and 2016. They were classified and evaluated using AOFAS score and radiographs to classify according to Van Dijk.
Results: The average age difference between triplanar and tillaux fractures is 17 months (p:0.038). The mean AOFAS Score was 85.2%. 88.8% reported pain in relation to daily activities, despite having excellent or good functional results. There is no significant correlation between the AOFAS results in patients with transitional and non-transitional fractures. 43.4% had stage 0, 43.4% stage I, and 13% stage II Van Dijk. No case presented stage III.
Discussion: Based on the findings of this study, and contrary to the hypothesized, most patients have a good functional result after the management of intra-articular ankle fractures and not excellent as previously thought. There is a group of patients who showed early degenerative changes demonstrable by radiography.
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References
Peterson HA. Epiphyseal growth plate fractures. Heidelberg: Springer;. 2007.
Vallejos Meana N, Krauthamer J.C, Merelas Rodriguez J. Fracturas de tobillo. En: Burgos, J., González Herranz, P., Amaya.
Peterson HA, Madhok R, Benson JT, IIstrup DM, Melton LJ. Physeal Fractures: Part 1. Epidemiology in Olmsted County. Minnesota, 1979-1988. J Pediatr Orthop. 1994;14:423-30. https://doi.org/10.1097/01241398-199407000-00002
Salter RB, Harris WR. Injuries involving the epiphyseal plate. J Bone Joint Surg (Am). 1963;45-A:587-622. https://doi.org/10.2106/00004623-196345030-00019
Flynn, John M., editor. II. Skaggs, David L., editor. III. Waters, Peter M., editor. IV. Title: Fractures in children.
Hirsch M, Flores F, Ardiles O, Ríos D. Comprendiendo las fracturas triplanares de la tibia distal. Rev Chilena Rad. 2016;22: 114-20. https://doi.org/10.1016/j.rchira.2016.09.002
Thomas M. Tiefenboeck Mark Schurz. Displaced juvenile Tillaux fractures: Surgicaltreatment and outcome. The central European Journal of Medicine. 2016;508:1-7.
Choudhry IK, Wall EJ, Eismann EA, Crawford AH, Wilson L. Functional outcome analysis of Triplane and Tillaux fractures after closed reduction and Percutaneous fixation. J Pe- diatr Orthop. 2013;34:139-43, https://doi.org/10.1097/BPO.0000000000000085
Claessen F. MDVdVM. Reliability for classification for posttraumatic ankle osteoarthritis. Knee Surg Sport Traumatol Arthrosc. 2016;24:1332-7. https://doi.org/10.1007/s00167-015-3871-6