Physeal fractures aboutthe ankle and osteochondral lesions of the talus in the skeletally immature athlete

In children and adolescents, many sports related ankle injuries result in physeal fractures. Excessive forces applied tothe skeletally immature ankle commonly result in Salter Harris 11, 111, and IV fractures. To minimize the potential for growth disturbance of the distal tibia and articular incongruity of the ankle joint, reduction with fixation is recornmended for fractures displaced greater than 2 mm. Transitional fractures of the ankle, ie, the juvenile Tillaux and triplane fractures, occur in the older adolescent athlete. Restoration of the articular surface is of primary importance in treating these injuries. Osteochondral lesions of the talus are often the cause of persistent ankle pain after a seemingly minor ankle injury. Immobilization and progressive rehabilitation are successful in treating the majority of these injuries in the immature athlete. Arthroscopic treatment techniques are recommended for treatment of osteochondral lesions not responsive to conservative measures.