Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Kau, T.
Age Relation and Classification of Ankel Injuries in Children
[ Dissertation ] Medical University of Graz; 2003. pp.
- Autor*innen der Med Uni Graz:
- Betreuer*innen:
- Höllwarth Michael
- Mayr Johannes
- Altmetrics:
- Abstract:
- Problem: Classification of ankle fractures are of two broad types: anatomical and mechanism-of-injury. Fracture patterns, pathomechanics, relation to risk for growth disturbances, and relevance for appropriate treatment are basic aspects, differently considered in existing classifications. It is suggested that one type of trauma could lead to different fracture types depending on skeletal maturity. For example, the physes are more likely to fail than are the ankle ligaments in children; the asymmetrical pattern of physeal closure, again, contributes to a high complexity of ankle fractures in adolescents. In the present study, we aimed to analyze the relation between types of injury and skeletal development of the ankle joint during maturation. With respect to both anatomical and traumatological investigations, distributions regarding sex and age should be pointed out. The collected material was to be classified. Finally, we tried to find out if a classification based on very typical injury patterns caused by a certain mechanism in defined age groups was possible to be established. Material and Methods: A total of 265 cases of ankle injuries in children and adolescents treated as out- and/or inpatients at the Department of Pediatric Surgery, University Hospital, Graz, were traced using AURA for a continuous period of 39 months starting in 1998. The diagnostic images were reevalutated, and data from the case records about age, sex, date of injury, mechanism of injury, and the basic type of treatment (conservative/operative) were collected. Primarily, injuries caused by direct trauma were divided from those caused by indirect trauma. The latter, amounting for 252 cases, were classified traumatologically with respect to existing classifications. The following classification of indirect trauma to the pediatric ankle was finally taken as a basis for further investigations: Supination-inversion injuries, supination-plantar flexion injuries, supination-external rotation injuries, supinatin injuries not further specified, pronation-eversion-external rotation injuries, and pronation-dorsiflexion injuries. Results: The incidence of ankle injuries increased in girls up to 12 years of age, in boys up to 13 years of age, forming the main peaks of frequency at these points. In both, this is also true after excluding pure ligament ruptures. Girls showed a minor peak at age 6 years, boys at age 8 years. Altogether, the age of highest incidence of ankle injuries in the pediatric population was 13 years with a minor peak at age 8 years.