title: Hawkins Group I fracture of neck of talus and Salter Harris Type III tibial epiphyseal injury of medial malleolus.
abstract: We are reporting an unusual combination of Hawkins Group I fracture of the neck of left talus in association with Salter Harris Type III distal tibial epiphyseal injury of medial malleolus in a child with cerebral palsy and hemiplegia of contralateral limbs and discussed the possible mechanism as well as management. Fractures of medial malleolus usually occur in Hawkins Group III fracture-dislocations in adults. Forced dorsiflexion of talus against the anterior edge of tibia appears to be the accepted common mechanism, despite limited experimental and clinical evidence incriminating axial compression. Fracture of medial malleolus implicates supination. We managed this unusual pattern of injury conservatively. At 15 months, the child was asymptomatic with no radiological evidence of avascular necrosis of body of talus or growth disturbance of distal tibial epiphysis.
authors: Prince Charles Hospital, Merthyr Tydfil, Mid Glamorgan CF47 9DT, United Kingdom. Electronic address: ambakrishna1950@yahoo.co.uk.
authors: Kodali Siva R K
authors: KS
authors: Prasad
authors: Hamza
authors: H
authors: Vali
authors: Altaf
authors: A
authors: Hussain
mesh_terms: D016512:Ankle Injuries / Q000145:classification / Q000000981:diagnostic imaging* / Q000628:therapy; D002370:Casts, Surgical; D002547:Cerebral Palsy / Q000150:complications; D002648:Child; D004838:Epiphyses / Q000000981:diagnostic imaging / Q000293:injuries; D050723:Fractures, Bone / Q000145:classification / Q000000981:diagnostic imaging* / Q000628:therapy; D006429:Hemiplegia / Q000150:complications; D006801:Humans; D008297:Male; D011859:Radiography; D013628:Talus / Q000000981:diagnostic imaging / Q000293:injuries*; D013977:Tibia / Q000000981:diagnostic imaging / Q000293:injuries*
keywords: Axial compression; Children; Clinical mechanism; Distal tibial epiphysis; Fracture neck of talus; Medial malleolus; Supination