Demographic distribution and injury patterns of ankle physeal fractures in children: a retrospective cohort study

INTRODUCTION: Ankle physeal fractures are a significant concern in paediatric populations due to their potential to cause growth disturbances, including premature physeal closure. The present study aimed to describe the epidemiology and injury patterns of ankle physeal fractures in children treated at a single university hospital centre in Switzerland over a 19-year period. MATERIALS AND METHODS: This retrospective cohort study included children aged 0 to 16 years who were admitted to our institution for an ankle physeal fracture between January 2004 and April 2023. Demographic and radiological data were collected, and fractures were classified according to the Salter-Harris and Dias-Tachdjian classifications. Statistical analyses, including Fisher’s exact test, were performed for dichotomous outcomes, with significance set at p<0.05. RESULTS: We included 259 patients with a mean age of 12.3 years old, mostly males (58.7%), with most fractures occurring among boys aged 14 and girls aged 12. Sports-related activities accounted for 51% of fractures, with the highest incidence in autumn. Isolated fractures of the distal tibia were most common (47.1%), and Salter-Harris type II fractures represented 51% of cases (p <0.05). The predominant mechanism of injury was supination–plantar flexion (33.6%). CONCLUSION: This study provided a comprehensive overview of the distribution and patterns of paediatric ankle physeal fractures. It underscored the need for future prospective multicentre studies to explore causative factors and outcomes related to growth disturbances. Targeted prevention and management strategies may help mitigate the incidence and consequences of these injuries.