A 9-year-old girl is brought to urgent care by her mother with right lateral ankle pain and inability to bear weight after she “rolled her ankle” while playing soccer. The physical examination reveals point tenderness over the lateral malleolus. You order x-rays of the ankle, which appear normal. Which of the following fractures is most likely?
a. Salter-Harris type I fracture of the distal tibia
b. Salter-Harris type I fracture of the distal fibula
c. Salter-Harris type V fracture of the distal tibia
d. Salter-Harris type V fracture of the distal fibula
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Answer: B. This patient would most likely be diagnosed with a Salter-Harris type I fracture of the distal fibula, based on her clinical presentation and the negative radiographs. However, recent studies have found that many presumed Salter-Harris type I fractures may actually be ligamentous injuries.
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