Clinical Pathways
Clinical Pathways
No Trauma
No Trauma

No Trauma

View The Full Pathway

Action

Consider:

  • Nonaccidental trauma
  • Toddler fracture and obtain x-ray (Class II)
  • Soft-tissue injury

Background

Nontraumatic Causes of Ankle and Foot Pain

Although trauma is the most common cause of pediatric ankle and foot injuries, there are many nontraumatic causes of ankle and foot pain in children. These include infectious, rheumatologic, inflammatory, neoplastic, and hematologic abnormalities. Table 2 includes a brief list of nontraumatic causes of pediatric ankle and foot pain.

image

‣
References
  1. Su AW, Larson AN. Pediatric ankle fractures: concepts and treatment principles. Foot Ankle Clin. 2015;20(4):705-719. (Review) DOI: 10.1016/j.fcl.2015.07.004
  2. Boutis K, Grootendorst P, Willan A, et al. Effect of the Low Risk Ankle Rule on the frequency of radiography in children with ankle injuries. CMAJ. 2013;185(15):E731-E738.(Clinical trial; 2151 children)
  3. Fleisher GR, Ludwig S, Anderson A. Injury-Ankle. In Fleisher GR, Ludwig S, eds. Textbook of Pediatric Emergency Medicine. 6th ed. Lippincott Williams and Wilkins; 2010:337-344. (Textbook chapter) ISBN: 978-1605471594
  4. Waterman BR, Owens BD, Davey S, et al. The epidemiology of ankle sprains in the United States. J Bone Joint Surg Am. 2010;92(13):2279-2284. (Research article, longtitudinal prospective study)
  5. Kramer DE, Cleary MX, Miller PE, et al. Syndesmosis injuries in the pediatric and adolescent athlete: an analysis of risk factors related to operative intervention. J Child Orthop. 2017;11(1):57-63. (Retrospective review; 220 children)
  6. Bible JE, Smith BG. Ankle fractures in children and adolescents. Tech Orthop.2009;24(3):211. (Review)
  7. Shea KG, Frick SL. Rockwood and Wilkins’ Fracture in Children. 8th ed. Lippincott Williams and Wilkins; 2015. (Textbook)
  8. Fleisher GR, Ludwig S, Bachman D, et al. Musculoskeletal trauma. In Fleisher GR, Ludwig S, ed. Textbook of Pediatric Emergency Medicine. 6th ed. Lippincott Williams and Wilkins; 2010:1335-1375. (Textbook chapter) ISBN: 978-1605471594
  9. Rammelt S, Heineck J, Zwipp H. Metatarsal fractures. Injury. 2004;35(2, Supplement):77-86. (Literature review)
  10. Cepela DJ, Tartaglione JP, Dooley TP, Patel PN. Classifications in brief: Salter-Harris classification of pediatric physeal fractures. Clin Orthop. 2016;474(11):2531-2537.(Review) DOI: 10.1007/s11999-016-4891-3
  11. Salter RB, Harris WR. Injuries involving the epiphyseal plate. J Bone Joint Surg Am. 1963;45(3):587-622. (Review)
  12. Margalit A, Peddada KV, Dunham AM, et al. Salter-Harris type II fractures of the distal tibia. Medicine (Baltimore). 2020;99(9):e19328. (Retrospective study; 59 patients)
  13. Solove M, Turcotte Benedict F. Ankle injuries in the pediatric emergency department. Pediatr Emerg Care. 2020;36(5):248-254. (Review) DOI: 10.1097/PEC.0000000000002097
  14. Koury SI, Stone CK, Harrell G, et al. Recognition and management of Tillaux fractures in adolescents. Pediatr Emerg Care. 1999;15(1):37-39. (Review)
  15. Leibner ED, Simanovsky N, Abu-Sneinah K, et al. Fractures of the lateral process of the talus in children. J Pediatr Orthop B. 2001;10(1):68. (Case reports; 2 children)
  16. Singh A, Lokikere N, Saraogi A, et al. Missed Lisfranc injuries-surgical vs conservative treatment. Ir J Med Sci. 2021;190(2):653-656. (Retrospective study; 17 patients)
  17. Robertson NB, Roocroft JH, Edmonds EW. Childhood metatarsal shaft fractures: treatment outcomes and relative indications for surgical intervention. J Child Orthop.2012;6(2):125-129. (Retrospective cohort; 337 patients)
  18. Smidt KP, Massey P. 5th metatarsal fracture. In: StatPearls. StatPearls Publishing; 2022. Accessed February 1, 2023. (Review)
  19. Bickley L. Bates’ Guide to Physical Examination and History Taking. 10th ed. Lippincott Williams and Wilkins; 2009. (Textbook) ISBN: 978-1605478036
  20. Reginelli A, Russo A, Turrizziani F, et al. Imaging of pediatric foot disorders. Acta Bio Medica Atenei Parm. 2018;89(Suppl 1):34-47. (Literature review)
  21. Hübner U, Schlicht W, Outzen S, et al. Ultrasound in the diagnosis of fractures in children. J Bone Joint Surg Br. 2000;82(8):1170-1173. (Comparative study; 163 children)
  22. LaBella CR. Common acute sports-related lower extremity injuries in children and adolescents. Clin Pediatr Emerg Med. 2007;8(1):31-42. (Review)
  23. D’Hooghe P, Alkhelaifi K, Abdelatif N, et al. From “low” to “high” athletic ankle sprains: a comprehensive review. Oper Tech Orthop. 2018;28(2):54-60. (Comprehensive review article)
  24. van Dijk CN, Longo UG, Loppini M, et al. Classification and diagnosis of acute isolated syndesmotic injuries: ESSKA-AFAS consensus and guidelines. Knee Surg Sports Traumatol Arthrosc. 2016;24(4):1200-1216. (Systematic review; 40 articles)
  25. Boutis K, Plint A, Stimec J, et al. Radiograph-negative lateral ankle injuries in children: occult growth plate fracture or sprain? JAMA Pediatr. 2016;170(1):e154114. (Prospective cohort study; 140 children)
  26. Boutis K, Willan AR, Babyn P, et al. A randomized, controlled trial of a removable brace versus casting in children with low-risk ankle fractures. Pediatrics. 2007;119(6):e1256-e1263. (Randomized controlled trial) DOI: 10.1542/peds.2006-2958
  27. Olgun ZD, Maestre S. Management of pediatric ankle fractures. Curr Rev Musculoskelet Med. 2018;11(3):475-484. (Review)
  28. Shamrock AG, Varacallo M. Triplane ankle fracture. In: StatPearls. StatPearls Publishing; 2022. Accessed February 1, 2023. (Review)
  29. Boutin A, Misir A, Boutis K. Management of toddler’s fracture: a systematic review with meta-analysis. Pediatr Emerg Care. 2022;38(2):49. (Systematic review; 4 studies, 355 participants) DOI: 10.1097/PEC.0000000000002488
  30. Sundararajan SR, Badurudeen AA, Ramakanth R, et al. Management of talar body fractures. Indian J Orthop. 2018;52(3):258-268. (Review)
  31. Paek S, Mo M, Hogue G. Treatment of paediatric Lisfranc injuries: a systematic review and introduction of a novel treatment algorithm. J Child Orthop. 2022;16(3):198-207.(Systematic review; 10 studies, 114 patients)
  32. Herrera-Soto JA, Scherb M, Duffy MF, et al. Fractures of the fifth metatarsal in children and adolescents. J Pediatr Orthop. 2007;27(4):427-431. (Retrospective study; 103 patients) DOI: 10.1097/01.bpb.0000271323.56610.da
  33. Fares MY, Salhab HA, Khachfe HH, et al. Sever’s disease of the pediatric population: clinical, pathologic, and therapeutic considerations. Clin Med Res. 2021;19(3):132-137.(Case study)
  34. Forrester RA, Eyre-Brook AI, Mannan K. Iselin’s disease: a systematic review. J Foot Ankle Surg. 2017;56(5):1065-1069. (Systematic review)
  35. Carmont MR, Rees RJ, Blundell CM. Current concepts review: Freiberg’s disease. Foot Ankle Int. 2009;30(2):167-176. (Review)

FacebookTwitterLinkedInInstagramYouTubePinterest

EB Medicine

FOAMed

Podcast

© EB Medicine. All rights reserved