Complications of Pediatric Foot and Ankle Fractures




Ankle fractures account for 5% and foot fractures account for approximately 8% of fractures in children. Some complications are evident early in the treatment or natural history of foot and ankle fractures. Other complications do not become apparent until weeks, months, or years after the original fracture. The incidence of long-term sequelae like posttraumatic arthritis from childhood foot and ankle fractures is poorly studied because decades or lifelong follow-up has frequently not been accomplished. This article discusses a variety of complications associated with foot and ankle fractures in children or the treatment of these injuries.




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    Children with chronic regional pain syndrome type I (CRPSI) have a higher preponderance of foot and ankle injuries than adults with CRPSI.




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    Children with chronic regional pain syndrome type I (CRPSI) have a higher preponderance of foot and ankle injuries than adults with CRPSI.




    • Ankle fractures account for 5% and foot fractures account for approximately 8% of fractures in children. Although there is abundant literature discussing adult treatment and outcomes (including complications) of foot and ankle trauma, there is a paucity of literature specifically discussing certain risks and treatments of ankle, and especially foot, injuries in children. Some complications, including compartment syndrome (CS), extensor retinaculum syndrome, reflex sympathetic dystrophy (RSD)/complex regional pain syndrome, infection, neurovascular injuries, and cast complications, are evident early in the treatment or natural history of foot and ankle fractures. Other complications, such as osteonecrosis (ON), missed injuries, premature physeal closure (PPC), malunion, nonunion, and arthrofibrosis, do not become apparent until weeks, months, or years after the original fracture. The incidence of long-term sequelae like posttraumatic arthritis from childhood foot and ankle fractures is poorly studied because decades or lifelong follow-up have not been accomplished to date. This article discusses a variety of complications associated with foot and ankle fractures in children or the treatment of these injuries. Foot fractures, including those of the phalanges, metatarsals, Lisfranc complex, talus, and calcaneus, and pediatric ankle fractures, including physeal, triplane, and Tillaux fractures, are described with a brief overview of each type followed by the complications unique to each fracture type. General complications associated with any pediatric foot or ankle injury are reviewed at the end of the article.








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