title: Unusual fracture combination in a paediatric acute ankle (combined medial talar compression fracture with medial malleolus fracture in an immature skeleton): a case report.
abstract: Talar compression fractures are uncommon orthopaedic injuries, especially in the immature skeleton. Fractures of the talar body constitute >5% of all foot and ankle fractures. The combination of a medial compression fracture and corresponding medial malleolar fracture is rare and not previously reported injury in the literature. We present a case report of a skeletally immature 15-year-old Caucasian male who sustained a medial malleolar and corresponding medial talus fracture after being ejected from his pushbike. This report outlines the potential difficulties in diagnosing an unusual fracture combination and the importance of initial management including necessary diagnostic imaging to identify such injuries. Through this case, we aim to highlight the need for having high suspicions of underlying fractures in paediatric trauma cases. The long-term complications and risks of osteonecrosis of the talus can have detrimental effect on a patient's outcome; therefore, we also emphasize the need for regular monitoring and long-term follow-up.
authors.affiliation: Department of Trauma and Orthopaedics, The Shrewsbury and Telford Hospital NHS Trust, Princess Royal Hospital, Telford, Shropshire, UK sebastien.crosswell@doctors.org.uk.
authors.forename: Sebastien
authors.initials: S
authors.lastname: Crosswell
authors.affiliation: Department of Trauma and Orthopaedics, University College London Hospitals NHS Foundation Trust, London, UK.
authors.forename: Shin-Jae
authors.initials: SJ
authors.lastname: Rhee
authors.affiliation: Department of Trauma and Orthopaedics, The Shrewsbury and Telford Hospital NHS Trust, Princess Royal Hospital, Telford, Shropshire, UK.
authors.forename: Wolfgang W
authors.initials: WW
authors.lastname: Wagner