• plantarflexion force displaces the tibial epiphysis posteriorly (SH I or II) • Thurston-Holland fragment is composed of the posterior tibial metaphysis and displaces posteriorly • occurs without fibular fracture • can be difficult to see on AP radiograph
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A 7-year old female injures her foot while rollerblading. She has mild swelling over the ankle with no neurovascular deficit and soft compartments throughout the lower extremity. Her radiographs are shown in Figures A and B. Which of the following sequelae is most commonly associated with this injury?
Increased external foot progression angle
Increased internal foot progression angle
Leg compartment syndrome
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A 12-year-old sustains an ankle injury while running on wet grass. Radiographs are shown in Figures A and B. A reduction maneuver is attempted under conscious sedation but fluoroscopic images are unchanged. What is the next best step in management?
Admit for observation
Cast immobilization and outpatient follow up in 4-6 weeks
Closed reduction under general anesthesia followed by cast immobilization
Open reduction and internal fixation
Repeat closed reduction under general anesthesia & internal fixation followed by cast immobilization
HPI - Fall and injury to left ankle
Is the closed reduction acceptable?
HPI - Twisting injury of left ankle while playing football
What is the best management option?
HPI - Twisting injury 4 hours ago
No prior pain or history of trauma