Foot and ankle fractures during childhood: review of the literature and scientific evidence for appropriate treatment

Bohler angle and the crucial angle of Gissane are used on the evaluation of calcaneus fractures. However, few authors have described the variation of the angles when the calcaneus is growing. In this study, Bohler angle and the crucial angle of Gissane in paediatric population were measured using lateral foot radiographs of 429 patients, from 0 to 16 years of age. The control group was composed of 70 adult patients. The sample had a mean Bohler angle of 35.4° ± 5.9° and a mean crucial angle of Gissane of 110.5° ± 7.4°. The greater mean difference was identified for Bohler angle (8°) in the age group of 5 to 8 years (39.6° ± 5.7°) and for the crucial angle of Gissane (5°-6°) in the age group of 0 to 4 years (115.8° ± 7.3) (P < .05). The influence of the ossification centres on the geometry of the calcaneus across age groups makes Bohler angle and the crucial angle of Gissane higher in young children. The increase in Bohler angle points out the relative development of the posterior facet in young children and the importance of the reconstruction of the posterior facet height in the intra-articular calcaneus fractures.Level of Evidence: Diagnostic study; Level III.

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“…The fracture incidence ranges between 0.05% and 0.15% and has a peak between 8 and 12 years of age. 1 The aetiology is similar to that of adults.…”

Section: Introductionmentioning

confidence: 85%

Bohler Angle and the Crucial Angle of Gissane in Paediatric Population

Pombo

Ferreira

Costa

2019

Clin Med�Insights�Arthritis�Musculoskelet Disord

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“…Foot and ankle fractures account for 12% of all pediatric fractures 72. Acute fractures in the pediatric population are unique because of the presence of the physis, which acts as an area of weakness, and usually the injury occurs through this region 10.…”

Section: Ankle Fracturesmentioning

confidence: 99%

Management of foot and ankle injuries in pediatric and adolescent athletes: a narrative review

Gill¹,

Klingele²

2018

ORR

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In this review, we focus on the treatment of injuries to the foot and ankle in the adolescent athlete. While many injuries in the adolescent foot and ankle are similar to or overlap with their counterparts in the adult population, the anatomy of the adolescent ankle, especially the presence of growth plates, results in different injury patterns in many cases and calls for specific management approaches. We discuss the unique anatomy of the pediatric patient as well as the diagnostic evaluation and treatment of common injuries in the young athlete.

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“…32,33 Biomehanička svojstva lokomotornog sustava djece znatno se mijenjaju ulaskom u pubertet, a ozljede distalne epifi ze tibije nastaju upravo u toj životnoj dobi. 34 U našem istraživanju, gledano prema dobnim skupinama, epifi zeolize distalne tibije najčešće se događaju dječacima u skupini od 10. do 15. godine, a djevojčicama između 8. do 13. godine. Indirektno zaključujemo da i zagrebačka djeca prate svjetski trend sve ranijeg ulaska u pubertet, osobito djevojčice.…”

Section: Raspravaunclassified

Distal Tibial Epiphyseal Fractures

2018

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Sažetak. Ozljeda epifi zne ploče rasta (epifi zeoliza) jedan je od prijeloma koji nalažu posebnu pozornost. Glavne su mu značajke velika pojavnost i neizvjestan ishod. Unatoč ispravnoj dijagnostici i liječenju epifi zeolize distalne tibije mogu nastati teške komplikacije (zastoj uzdužnog rasta i/ili progresivna deformacija). Budući da su kurativne metode nemoćne kod težih oblika epifi zeoliza, preventivnim mjerama treba barem ublažiti težinu i smanjiti pojavnost ovih ozljeda. Pojavnost i tip prijeloma u djece uvjetovani su brojnim čimbenicima (dob, spol, pretežito ponašanje djece, karakteristika mjesta na kojima djeca borave...), a razlikuju se ne samo od regije do regije već i od grada do grada. U ovom radu analizirano je 197-ero zagrebačke djece koja su od 1. 1. 2010. do 1. 1. 2017. liječena zbog ozljede distalne epifi ze tibije. Zbog nepotpunih podataka iz studije je isključeno 80-ero djece. Ukupno je analizirano 117-ero zagrebačke djece. Njih 37-ero liječeno je u Kliničkome bolničkom centru Zagreb, a 80-ero u Klinici za dječje bolesti Zagreb. U ispitanom uzorku bilo je 88 (69,2%) dječaka i 29 (30,8%) djevojčica. Srednja dob u trenutku ozljeđivanja bila je 12,3 godine, pri čemu su dječaci bili u prosjeku 17 mjeseci stariji od djevojčica. Prema mehanizmima ozljede, većinom se radilo o padovima (58 (49,9%)), a kao najčešća mjesta izdvajaju se sportske površine (36 (30,8%)) te kod kuće (27 (23,1%)). Prema šifri aktivnosti, najčešće su rekreativne (52 (44,4%)) i sportske aktivnosti (47 (40,2%)). Najčešća sportska aktivnost je igranje nogometa. Stoga preventivne mjere treba usmjeriti ponajprije na mušku djecu školske dobi, tijekom sportskih i rekreativnih izvanškolskih aktivnosti, posebice u nogometu. Descriptors: Tibial fractures-classifi cation, epidemiology, etiology; Epiphyses-injuries; Salter-Harris fractures; Growth plate; Accidental falls-statistics and numerical data; Athletic injuries-statistics and numerical data; Accident prevention; Child; Croatia-epidemiology Summary. Distal tibial epiphyseal fractures are signifi cant because they often cause tibial growth disturbance. Distal tibial epiphyseal fractures are the second most common epiphyseal fractures, after distal radial epiphysis. Despite prompt diagnosis and correct treatment, serious complications, such as progressive deformation and permanent disability, are possible. Therefore, it is necessary to prevent these injuries. Prevention is possible only by studying injury pattern, mechanism and locations where fractures occur. In total, medical records of 197 children treated for distal tibia epiphyseal fracture in the period from January 1st , 2010 to January 1st , 2017 were analyzed. Due to insuffi cient data, 80 of them were excluded from the study. Thirty-seven children were treated in Clinical Hospital Center Zagreb and eighty in the Children's Hospital Zagreb. In the studied group of children, there were 81 (69.2%) boys and 36 (30.8%) girls. The average age at the time of injury was 12.3 years, with boys being on average 17 months older than girl...

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Foot and ankle fractures during childhood: review of the literature and scientific evidence for appropriate treatment

Cited by 21 publications

References 58 publications

Bohler Angle and the Crucial Angle of Gissane in Paediatric Population

Bohler Angle and the Crucial Angle of Gissane in Paediatric Population

Management of foot and ankle injuries in pediatric and adolescent athletes: a narrative review

Distal Tibial Epiphyseal Fractures

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