Ankle fractures: Ankle fractures in the skeletally immature usually involve the growth plates of the tibia or fibula (the two shin bones). They usually occur as a result of a twisting injury to the ankle. An adult with the same type of injury would have an ankle sprain (a tear in a ligament). Most of the ankle fractures seen in children do not require operative management, but do if the fracture line extends into the joint. Injury to the growth plate may, on occasion, result in a growth disturbance.
Ankle sprains: Ankle sprains in children are rare because the ligaments are stronger than the growth plate, and the growth plate fails first under the "load" of injury. When they do occur, some form of immobilization (cast or brace) is indicated in order for the ligaments to heal at their normal length. Ligaments that heal in a "lengthened" position result in long-term disability and the increased likelihood of repeated ankle sprains under even minimally vigorous loads.
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