title: Radiographic diagnosis of occult distal fibular avulsion fracture in children with acute lateral ankle sprain.
abstract: BACKGROUND
  Skeletally immature children with ankle sprain are presumed to have distal fibula fracture than ligamentous injury. The purpose of this study is to determine the incidence of associated occult avulsion fracture in children with lateral ankle sprain and the efficacy of identifying fractures using anterior talofibular ligament view.
  
  
  METHODS
  Patients who were diagnosed with distal fibular fracture in the initial ankle anteroposterior, lateral, and mortise were excluded and 78 patients (below 16 y of age) who had been initially diagnosed as ankle sprain were included. The initial and 4 weeks' follow-up ankle series and additional anterior talofibular ligament view suggested by Haraguchi were evaluated.
  
  
  RESULTS
  Twenty patients were diagnosed with occult distal fibular avulsion fracture. Ten patients were diagnosed in anterior talofibular ligament view and others were diagnosed in the follow-up radiography. Displacement was highest on the anterior talofibular ligament view.
  
  
  CONCLUSIONS
  This study found 20 (26%) of 78 ankle sprain show occult avulsion fracture in the anterior talofibular ligament view or follow-up radiography. The anterior talofibular ligament view is an appropriate radiologic view for the diagnosis of distal fibular avulsion fracture.
  
  
  METHODS
  Level IV--diagnostic study.
authors.affiliation: *Department of Orthopaedic Surgery, Hallym Sacred Heart Hospital, Hallym University College of Medicine, Anyang Departments of †Orthopedic Surgery §Physical Medicine and Rehabilitation, Haeundae Paik Hospital, Inje University College of Medicine ‡Clinical Trial Center, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea.
authors.forename: Yoon-Hae
authors.initials: YH
authors.lastname: Kwak
authors.forename: Jae-Young
authors.initials: JY
authors.lastname: Lim
authors.forename: Min-Kyung
authors.initials: MK
authors.lastname: Oh
authors.forename: Woo-Jin
authors.initials: WJ
authors.lastname: Kim
authors.forename: Kun-Bo
authors.initials: KB
authors.lastname: Park
mesh_terms: D000293:Adolescent; D016512:Ankle Injuries / Q000150:complications / Q000175:diagnosis; D000843:Ankle Joint / Q000000981:diagnostic imaging; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005260:Female; D005360:Fibula / Q000000981:diagnostic imaging / Q000293:injuries; D005500:Follow-Up Studies; D005596:Fractures, Closed / Q000175:diagnosis / Q000209:etiology; D017759:Fractures, Malunited / Q000175:diagnosis / Q000209:etiology; D006801:Humans; D017844:Lateral Ligament, Ankle / Q000000981:diagnostic imaging; D008297:Male; D011859:Radiography; D015203:Reproducibility of Results