Сomputed tomography for fractures of the ankle joint in children

Introduction. Correct diagnosis is based on visualization and knowledge of fracture patterns characteristic of children. Traditionally, radiography is used to visualize bone damage. In fractures in children due to the high risk of damage to the germinal zones, it is necessary to have clear and reliable information about their condition, which cannot always be obtained by x-ray method. For these purposes and the requirements of modern surgery, CT is used, which with high diagnostic accuracy clarifies the degree of displacement of fragments, present a qualitative characteristic of fractures and reveals associated damage.

Purpose: to show the capabilities of computed tomography in diagnosis of fractures of ankle joint.

Materials and methods. The results of computed tomography (CT) are presented in 226 children and adolescents aged 3 to 17 years. There were 142 boys (62.8%), 84 girls (37.2%). Scanning was carried out depending on the weight and age of the patient with the minimum indicators of kV and mAS, a slice thickness of 0.75 mm.

Results. Average time for seeking medical help was 32 hours from moment of injury. Among causes of injury in the first place was domestic injury (73, 8%), followed by sports injury (22, 3%) and traffic accidents (3.9%). Right-sided ankle fractures were found in 147 (65.1%), left-sided – in 79 (34.9%) children. The most common types of tibial fractures were metaepiphysiolysis of the distal tibia and metaepiphysiolysis of the distal tibia of both tibia, which together accounted for 67.7% (n = 153) of all tibial fractures.

Conclusion. Computed tomography should be performed in all cases of intraarticular fractures of the ankle joint. It is especially important for evaluating fractures with damage to germ zones. Scanning must be carried out with a cutting thickness of not more than 1 mm. CT with multi-planar data reformatting is an important factor in determining whether a patient needs surgical treatment. As a result of CT, a final diagnosis was established and a decision was made on treatment tactics.

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