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Outcomes Following Supination-Inversion Ankle Fractures in Children
Nathan Bascom, BS1, Charles T. Mehlman, DO, MPH2, Jamie R. Denning, MD2, Shital N. Parikh, MD2, Katherine Schroeder, MD3. 1Ohio University College of Medicine, Athens, OH, USA, 2Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA, 3University of Cincinnati College of Medicine, Cincinnati, OH, USA.

Background: This study analyzed the clinical and radiographic outcomes following the most common ankle fracture pattern in children: Dias-Tachdjian supination-inversion injuries.

Methods: We performed a chart and x-ray review of patients who sustained supination-inversion type II injuries from 2003-2014. Inclusion criteria were skeletally immature patients with radiographic follow-up of: a) one year, or b) 6 months with obvious growth resumption as indicated by Park-Harris growth lines parallel to the physis. Fracture displacement was recorded. Evidence of growth disturbance and other complications were sought. Patients were contacted by phone to complete the FAOS (Foot and Ankle Outcome Score).

Results: There were 47 patients in the surgical group and 7 in the non-surgical group. The average surgical group age was 12 yrs (range 7-15 yrs) and the average non-surgical age was 11 yrs (range 6-14.5 yrs). There was a 15% (7/47) major complication rate in the surgical group. Fisher Exact test revealed that there was a significantly (p=0.025) higher rate of complications in the non-surgical group (57%, 4/7). There was a significantly higher (p=0.019) rate of complications in the surgical group when post-operative fracture displacement was > 2 millimeters. No significant differences in FAOS scores were detected.

Conclusions: When comparing surgical and non-surgical treatment of supination-inversion type II injuries we found a statistically higher complication rate with non-surgical treatment.


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