1. Is lateral ankle sprain of the child and adolescent a myth or a reality? A systematic review of the literature
- Author
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Thomas W. Bauer, Georges El Khoury, Alexandre Hardy, Grégoire Rougereau, Thibaut Noailles, and Tristan Langlais
- Subjects
medicine.medical_specialty ,Lateral ankle ,Adolescent ,Population ,Avulsion ,03 medical and health sciences ,Fractures, Bone ,0302 clinical medicine ,Medicine ,Humans ,Orthopedics and Sports Medicine ,Ankle Injuries ,education ,Child ,030222 orthopedics ,education.field_of_study ,business.industry ,Incidence (epidemiology) ,Anterior talofibular ligament ,030229 sport sciences ,medicine.disease ,Surgery ,medicine.anatomical_structure ,Fibula ,Orthopedic surgery ,Sprains and Strains ,Ankle ,business ,Lateral Ligament, Ankle ,Ankle Joint ,Pediatric trauma - Abstract
Background Ankle trauma in children and adolescents is the most common orthopedic injury encountered in pediatric trauma. It has long been recognized that a lateral ankle injury in this population is often a Salter and Harris type I fracture of the distal fibula (SH1). The purpose of this study is to confirm the existence of a lateral ankle sprain and to report the incidence of each pathology of the lateral ankle compartment: SH1 fracture, ATFL injury, and osteochondral avulsions. Methods A systematic review of the literature is done using the database provided by PubMed and Embase. All articles reporting the incidence of imaging modality-confirmed lateral ankle injury (SH1, ATFL injury, osteochondral avulsion) in children and adolescents were included. Exclusion criteria were the following: case reports or articles with less than ten subjects, unspecified imaging modality and articles unrelated to lateral ankle lesions. Thus, 237 titles and abstracts were selected, 25 were analyzed thoroughly, and 11 articles were included for final analysis. Results SH1 fractures were found in 0–57.5% of the cases in all series and 0–3% in the most recent series. A diagnosis of an ATFL injury was found in 3.2–80% and an osteochondral avulsion of the distal fibula in 6–28.1%. The most recent series report 76–80% and 62% for ATFL injury and osteochondral avulsion respectively. Conclusions There is a non-negligible incidence of ATFL sprains and fibular tip avulsions in patients with a suspected SH1 fracture of the distal fibula. According to recent evidence and MRI examinations, the most common injuries of the pediatric ankle are ATFL sprain and osteochondral avulsions. This should be taken into consideration in daily practice when ordering radiological examination and deciding on treatment modalities
- Published
- 2021