Question 1

Will this fracture affect my child's growth or cause one leg to be shorter?

Accepted Answer

Risk of growth problems is low (less than 5%) if fracture treated promptly and properly aligned - the ankle growth plate contributes about 40% of lower leg length, so damage could theoretically cause leg length difference, but this rarely happens with appropriate treatment. Growth disturbance more likely with: (1) severely displaced fractures (especially if treatment delayed more than 5-7 days), (2) fractures that crush or compress the growth plate (rather than clean breaks through the plate), or (3) infection after surgery. Your child's surgeon will monitor growth with X-rays at 3, 6, and 12 months after injury - if growth plate injured but still functioning, you'll see continued bone growth on X-rays; if growth plate damaged (premature closure), bone growth stops and leg gradually becomes shorter. If significant leg length difference develops (more than 1-2cm), treatment options include shoe lift, growth modulation of the other leg (slowing good leg's growth to allow injured leg to catch up), or limb lengthening surgery in severe cases (rare, less than 1-2% of ankle growth plate fractures). REASSURANCE: 95%+ of children have normal growth after these fractures with no leg length difference.

Question 2

How can we tell if it's a fracture versus a bad ankle sprain - do we need to go to the emergency department?

Accepted Answer

Distinguishing fracture from severe sprain can be difficult (both cause pain, swelling, difficulty walking), but certain signs suggest fracture requiring urgent evaluation: (1) INABILITY TO BEAR WEIGHT: If your child cannot put any weight on foot at injury scene AND four hours later, fracture more likely than sprain (sprains usually allow some weight-bearing after initial pain settles) - (2) POINT TENDERNESS OVER BONE: If you gently press on inside or outside ankle bone and your child has sharp localized pain (rather than diffuse aching), suggests fracture - (3) DEFORMITY: Any obvious crookedness or deformity is fracture until proven otherwise - (4) SEVERE SWELLING: Rapid swelling (within 1-2 hours) suggests fracture, while sprains typically swell gradually over 4-12 hours - (5) MECHANISM: High-energy injuries (falls from height, motor vehicle accidents) or severe twisting with audible pop/crack more likely fractures. WHEN TO GO TO EMERGENCY: Take your child to ED if unable to bear weight 4 hours after injury, obvious deformity, severe pain uncontrolled by paracetamol/ibuprofen, or numbness/tingling in foot. WHEN TO SEE GP: If able to limp/walk with pain, swelling moderate, and pain controlled with over-the-counter medications, can see GP next day - GP will examine and order X-rays if concerned. IF IN DOUBT, GET X-RAYS: Growth plate fractures can look like simple sprains clinically, so lower threshold for X-rays in children/teenagers than adults - better to X-ray and find no fracture than miss growth plate fracture and risk treatment delay.

Question 3

When can my child return to sports after this fracture?

Accepted Answer

Return to sports is gradual process taking 10-16 weeks depending on fracture severity and sport demands - timeline: WEEKS 1-6 (HEALING PHASE): In cast/boot, non-weight-bearing initially, no sports - focus on maintaining fitness with upper body exercises, swimming with pool buoy (if approved by doctor) | WEEKS 6-10 (REHABILITATION PHASE): After cast removal, active physiotherapy - ankle range of motion exercises (alphabet drawing with foot, calf stretches), strengthening (resistance band exercises, calf raises), balance training (single leg standing, wobble board) - gentle non-impact activities allowed (swimming, cycling, elliptical) once walking normally without pain | WEEKS 10-14 (RETURN TO SPORT PHASE): Gradual progression to sport-specific activities - start with straight-line jogging, progress to running, then cutting/pivoting drills - must achieve: full ankle motion (same as uninjured ankle), 90%+ strength (measured by calf raises - should do same repetitions on injured vs uninjured side), confident single-leg balance (60 seconds no wobbling), pain-free sport-specific movements | WEEK 12-16 (FULL RETURN): Return to full competition once above criteria met - may need ankle brace/taping for first 4-6 weeks back (reduces re-injury risk). SPORT-SPECIFIC TIMELINES: Non-contact sports (swimming, cycling) 8-10 weeks | Running sports (cross-country, track) 10-12 weeks | Contact sports (football, basketball, soccer) 12-14 weeks | High-impact sports (gymnastics, trampolining) 14-16 weeks. CRITICAL: Don't rush return - re-injury risk very high if return before full strength/motion restored (25-30% re-injury rate if return early vs less than 5% if wait until full recovery). Your child's physiotherapist and surgeon will guide timeline based on individual progress.

Medical Disclaimer

Ankle Growth Plate Fractures in Teenagers

📖What is Ankle Growth Plate Fractures in Teenagers?

🔬What Causes It?

⚠️Risk Factors

You may be at higher risk if:

🛡️Prevention