Pediatric Distal Tibia Physeal Injury Presenting with Acute In-toeing: A Case Report and Literature Review.

Document Type

Article

Publication Date

8-2-2023

Publication Title

Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews

Abstract

Ankle fractures are among the most common fractures sustained in the pediatric population. Given the frequency of physeal involvement of the distal fragment, complications including growth arrest, overgrowth, and rotational deformities are not uncommon. This case report describes a 12-year-old adolescent boy who presented after an acute right ankle injury sustained while playing. He noted right ankle pain, swelling, and in-toeing of his foot. Radiographs of the ankle demonstrated a distal tibia Salter-Harris type II fracture that appeared nondisplaced. However, a CT scan of the ankle demonstrated a 60° difference in the rotational profile between the injured and noninjured tibias. The patient's acute rotational deformity was corrected with closed reduction and percutaneous pinning. Pediatric distal tibia physis fractures presenting with in-toeing are rare and difficult to diagnose accurately with radiographs alone. Accordingly, a detailed history, physical examination, comparison radiographs, and CT scans are imperative in making the correct diagnosis and determining the appropriate treatment.

Volume

7

Issue

8

First Page

e22.00134

DOI

10.5435/JAAOSGlobal-D-22-00134

ISSN

2474-7661

PubMed ID

37535815

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