Twenty seven patients with acute avulsion fractures of the anterior talofibular ligaments were evaluated clinically. These were selected from 48 patients below 15 years of age who had acute injuries of the lateral collateral ligaments of the ankles.
In 6 of the cases, bone fragments were not visible on the initial plane or stress radiographs. Five of these 6 cases were below 10 years of age.
All 27 avulsion fractures were surgically treated, and bone fragments were fixed with tension band technique, wire suture, or suture with biodegradient material. Twenty six were asymtomatic in post oparative evaluation. Only 1 case showed slight loss of motion range of the ankle joint. Bone unions had been obtained in 25 cases. Only in 1 case there remained marked talar tilting.
We have concluded that in patients below 10 years of age, who have marked talar tiltings, avultion fractures should be suspected even if bone fragments are not visible on the radiographs. Surgical fixations can correct these injuries by in large.
