• C J Van Laarhoven and C H Van der Werken.
• Academisch Ziekenhuis, afd. Heelkunde, Utrecht.
• Ned Tijdschr Geneeskd. 1996 Nov 23; 140 (47): 2337-41.

ObjectiveEvaluation of the long-term results of protocolled treatment of ankle fractures in childhood.SettingSt Elisabeth Hospital, Tilburg, the Netherlands.DesignRetrospective long-term follow-up study.MethodAll 78 children with an ankle fracture and an open epiphyseal plate in the period 1985-1989 were treated according to a protocol which specified the indications for conservative or surgical therapy depending on the particular fracture type according to Salter and Harris. After a median follow-up period of 3.42 years (range: 2.08-7.67 years) in 48 patients the treatment results could be evaluated in 92% of these patients. Thirty patients had an isolated fracture of the distal part of the fibula.ResultsA clinically 'good' or 'excellent' result was achieved in 100% of the patients, and an 'excellent' result in 68%.ConclusionsGrowth disturbances after an ankle fracture in children with an open epiphyseal plate can now be restricted to the very rare fractures with severe damage to the germinative layer of the epiphyseal plate. In general, conservative treatment should be used in Salter and Harris I and II fractures and operative treatment in displaced Salter and Harris III and IV fractures.

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