ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2019
Avulsion fracture of the distal fibula is associated with recurrent sprain after ankle sprain in children.
Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07751068 (Prevention of the Os Fibulare After an Acute Lateral Ankle Avulsion Fracture in Pediatric Patients), which is not on this map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Prevention of the Os Fibulare After an Acute Lateral Ankle Avulsion Fracture in Pediatric Patients: A Randomized Control Trial
Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it, 35 citations in OpenAlex.
- Surgical outcome of avulsion fractures of the distal fibula: a systematic literature review.Archives of orthopaedic and trauma surgery · 2023Pooled it
- A novel classification system for avulsion fractures of the distal fibula based on arthroscopy-assisted measurement and significance to surgery and rehabilitation.Frontiers in medicine · 2026Article
- Enhanced subfibular ossicle diagnosis: CT-MRI integration of morphology and ligament attachments.Insights into imaging · 2025Article
- Age- and gender-specific magnetic resonance imaging findings in paediatric ankle trauma with negative radiographs.BMC musculoskeletal disorders · 2025Article
- Is it necessary to remove small fibular ossicles during an arthroscopic modified Broström operation for chronic lateral ankle instability?BMC musculoskeletal disorders · 2025Article
- Article
- Satisfactory outcomes from the double-row fixation procedure for ankle lateral ligaments injury with os subfibulare.Asia-Pacific journal of sports medicine, arthroscopy, rehabilitation and technology · 2024Article
- Addressing the Need for a Better Understanding of Foot and Ankle Pathology Relevant to the Adolescent Athlete.Children (Basel, Switzerland) · 2023Article
- [Comparison of short-term effectiveness of metal screws and absorbable screws in repair of distal tibiofibular syndesmosis].Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2022Article
- Distal insertion rupture of lateral ankle ligament as a predictor of weakened and delayed sports recovery after acute ligament repair: mid-term outcomes of 117 cases.BMC musculoskeletal disorders · 2022Article
- [Progress in diagnosis and treatment of fibular fracture in ankle fracture].Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2022Article
- Lateral Ankle Sprains and Their Association with Physical Function in Young Soccer Players.Open access journal of sports medicine · 2021Article
- Diagnosis of avulsion fractures of the distal fibula after lateral ankle sprain in children: a diagnostic accuracy study comparing ultrasonography with radiography.BMC musculoskeletal disorders · 2020Article
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Authors and funding
9 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe purpose of this study was to clarify radiographic and clinical outcomes, as well as their association, of ankle sprain in children.
methodsPatients who sustained a first-time ankle sprain were prospectively surveyed. Patients underwent radiography of the ankle in the mortise, lateral, anterior talofibular ligament (ATFL), and calcaneofibular ligament views at the first clinic visit to assess avulsion fractures of the distal fibula. Patients with avulsion fractures underwent radiography after 8 weeks to assess bone union. The treatment method was not standardized and was determined by the patient, their parents, and the treating physician. Recurrent sprain and quality of life were evaluated by using the Self-Administered Foot Evaluation Questionnaire and reviewing the medical records of patients. The association between avulsion fracture and recurrent sprain was assessed using univariate and multivariate analyses.
resultsA total of 143 patients with a median age of 9 (range 6-12) years were analyzed. Avulsion fractures were present in 89 (62%) patients. The sensitivity of the ATFL view for the diagnosis of avulsion fractures was 0.94, whereas that for the anteroposterior and lateral views was significantly lower at 0.46 (P < 0.001). Only 17% of fractures united at 8 weeks. Of 114 (follow-up rate, 80%) patients who were followed up for a median period of 24 months, recurrent sprain occurred in 41 (36%) patients. The incidence rate was significantly higher in patients with avulsion fractures than in patients without the fractures (44 vs. 23%, P = 0.027). In multivariate logistic regression analysis, avulsion fracture was independently associated with recurrent sprain (P = 0.027).
conclusionMore than one-third of patients experienced recurrent sprain. The presence of avulsion fracture was associated with an increased risk of recurrent sprain. Patients with avulsion fracture and their parents should be informed about the risk of recurrent sprain and subsequent ankle instability, and careful follow-up is needed for these patients. LEVEL OF EVIDENCE: III.
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