From the Research
The treatment for an undisplaced fracture of the lateral malleolus with a Salter-Harris type 1 component involves immobilization with a non-weight bearing cast or walking boot for 4-6 weeks, as this approach prioritizes the prevention of growth disturbances and promotes proper healing, with the most recent and relevant evidence supporting this treatment approach found in 1.
Treatment Approach
The treatment approach for an undisplaced fracture of the lateral malleolus with a Salter-Harris type 1 component should prioritize immobilization to prevent growth disturbances and promote proper healing.
- Immobilization with a non-weight bearing cast or walking boot for 4-6 weeks is recommended, with the initial 3-4 weeks in a short leg cast and the remaining 2-3 weeks in a removable walking boot.
- Weight-bearing status should be non-weight bearing for the first 2-3 weeks, then progress to partial weight bearing as tolerated.
- Regular follow-up with orthopedics at 2,4, and 6 weeks with radiographs is necessary to monitor healing.
- Pain management includes acetaminophen or NSAIDs as needed.
- Physical therapy should begin after cast removal to restore range of motion, strength, and proprioception.
Rationale
This treatment approach is recommended because Salter-Harris fractures involve the growth plate, and proper immobilization is crucial to prevent growth disturbances while allowing the fracture to heal.
- Since the fracture is undisplaced and the ankle mortise is maintained, surgical intervention is not necessary, but close monitoring is essential to ensure proper healing and to detect any potential growth complications.
- The most recent and relevant evidence supporting this treatment approach is found in 1, which highlights the importance of immobilization and close monitoring in the treatment of pediatric lateral ankle injuries, including Salter-Harris type 1 fractures.
- While other studies, such as 2, 3, 4, and 5, provide information on the treatment of lateral malleolar fractures, they are not directly relevant to the treatment of an undisplaced fracture with a Salter-Harris type 1 component, and therefore, do not influence the recommended treatment approach.