![]() ![]() ![]() Crutches can be used until the patient can weight bear without a limp, although early mobilisation with analgesia should be encouraged.Ankle sprains/ligamentous injuries can be managed with simple analgesia, rest, ice, compression and elevation.The most common ligament injured is the anterior talofibular ligament – there is maximal tenderness just anterior to the distal fibula.Be careful of diagnosing ankle sprains in pre-pubescent children, undisplaced Salter-Harris I distal fibula fractures are commonly missed.Ankle sprains are more common in older adolescents once their growth plates have fused.Displaced physeal and triplane fractures may need a CT scan.įor general assessment and management, see Fractures - Overview.Children under 2 years of age should have AP and lateral views of the full-length tibia and fibula.An ankle X-ray should have anterior posterior (AP), mortise, and lateral views, and include the proximal end of the metatarsals.Assess passive and active movement of the ankle joint.Assess the child’s ability to weight bear after analgesia.There may be clinical deformity of the ankle joint.There is usually localised swelling and tenderness over one or both malleoli.R ead the full PCH Emergency Department disclaimer. Clinicians should also consider the local skill level available and their local area policies before following any guideline. These clinical guidelines should never be relied on as a substitute for proper assessment with respect to the particular circumstances of each case and the needs of each patient. Clinical common-sense should be applied at all times. They are not strict protocols, and they do not replace the judgement of a senior clinician. ![]() These guidelines have been produced to guide clinical decision making for the medical, nursing and allied health staff of Perth Children’s Hospital. ![]()
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