Ankle fractures patterns in children may vary depending on the maturity of the distal tibial and fibular physis. Bimalleolar ankle fracture is an exceedingly rare fracture pattern in children and has been reported once in the current English literature. Two further adolescents with bimalleolar ankle fracture are reported. Although these fractures are rare, surgeons should be aware of these atypical fracture patterns. Herein, the underlying physiology and the mechanism of injury of ankle fractures in children are discussed.
Level of Evidence: Therapeutic, Level IV, Case study
LandinLA. Fracture patterns in children. Analysis of 8682 fractures with special reference to incidence, etiology, and secular changes in Swedish urban population, 1959-1979. Acta Orthop Scand. 1983;54:1-109.
2.
SpiegelPGCoopermanDRLarosGS. Epiphyseal fractures of the distal ends. A retrospective study of two hundred and thirty seven cases in children. J Bone Joint Surg Am. 1978;60:1046-1050.
3.
PetersonCAPetersonHA. Analysis of the incidence of injuries to the epiphyseal growth plate. J Trauma. 1972;12:275-281.
4.
SchnetzlerKAHoernschemeyerD. The pediatric triplane ankle fracture. J Am Acad Orthop Surg. 2007;15:738-747.
5.
Von LaerL. Classification, diagnosis, and treatment of transitional fractures of the distal part of the tibia. J Bone Joint Surg Am. 1985;67:687-698.
6.
WeinbergAMJablonskiMCastellaniCKoskeCMayrJKastenP. Transitional fractures of the distal tibia. Injury. 2005;36:1371-1378.
7.
KleigerBMankinHJ. Fractures of the lateral portion of the distal tibia epiphysis. J Bone Joint Surg Am. 1964;46:25-31.
8.
Lauge-HansenN. Fractures of the ankle. II. Combined experimental-surgical and experimental-roentgenologic investigations. Arch Surg. 1950;60:957-985.
9.
DiasLSTachdjianMO. Physeal injuries of the ankle in children: classification. Clin Orthop. 1978;(136):230-233.
10.
SalterRBHarrisWR. Injuries involving the epiphyseal plate. J Bone Joint Surg Am. 1963;45:587-622.
11.
WoodMBBierADOtsukaNY. Bimalleolar ankle fracture in an adolescent with Tillaux fracture. J Surg Orthop Adv. 2009;18:103-105.
12.
KimJRSongKHSongKJLeeHS. Treatment outcomes of triplane and Tillaux fractures of the ankle in adolescence. Clin Orthop Surg. 2010;2:34-38.