Weekend Clinic for Injuries

Sprains, strains and broken bones don’t wait for weekdays. If your child needs to see a pediatric orthopedic expert on a weekend, Children’s has appointments available on Saturdays in Sandy Springs and Sundays in Duluth. Make an appointment online or call 404-255-1933 to schedule.

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Toe, foot and ankle conditions can be congenital (present at birth) or acquired, meaning it is caused by an injury, an infection, arthritis or a tumor. At Children’s Healthcare of Atlanta, our pediatric orthopedic specialists are specially trained to diagnose and treat all toe, foot and ankle conditions and injuries in babies, kids, teens and young adults through age 21.

Acquired conditions 

Acquired deformities of the toe, foot or ankle may be caused by:

  • Injury to a child’s growth plate
  • Trauma to joint surfaces
  • Fracture malunions (the bone doesn’t heal properly)
  • Neuromuscular deformities, such as muscular dystrophy, Charcot-Marie-Tooth disease, tethered cord, spasticity, infection or tumors

Congenital conditions

Congenital toe, foot and ankle disorders can be genetic, and while many are present at birth, some may not be noticeable until your child is a teen.

Whether your child stubs his toe or is born with a condition in which his toes are bending the wrong way, there are a variety of toe conditions and injuries that can affect a child.

At Children’s, we are specialists at diagnosing and treating the following:

Mallet toe refers to the downward bending of the third joint near the end of the toe, giving it a mallet-like appearance. Corns or calluses may develop over the deformity as a result of constant friction against a child’s footwear. Mallet toe can be inherited or may develop from wearing shoes that are too tight or high-heeled.

Your child will undergo a medical and physical exam in which a doctor will look at his foot to see if the toe joint is fixed or flexible. Your child may also need blood flow testing, a Doppler ultrasound or a nerve test if the doctor thinks your child has nerve problems in his foot.

A toe joint that moves some can often be managed without surgery. However, a fixed joint may require pediatric orthopedic surgery. This will require an X-ray to help the doctor determine what type of surgery will be most successful. Surgery may also be necessary if other treatments don’t control pain, if your child’s toe limits his activity or if your child can’t move his toe joint.

Claw toe is a rare deformity that affects the toe joints, making them flex over to resemble a claw. Claw toe can occur along with cavus foot, Charcot-Marie-Tooth disease or myelomeningocele and can result from changes in your child’s structural anatomy and/or neurological disorders that may cause muscle imbalances.

After reviewing your child’s medical history and giving him a physical exam, a doctor may recommend your child get an X-ray or require tests to rule out a neurological disorder that could be weakening the foot muscles and creating imbalances that bend his toes.

Treatment for claw toe may vary and depends on what caused the condition and whether your child’s toe joints are rigid or flexible. If the toe joints are flexible, your child’s doctor may recommend orthotics, or specific shoes, cushions, linings and pads, to help absorb force when walking and place the toes in the proper position. If the toe deformity is causing problems with shoe wear, your child’s doctor may recommend pediatric orthopedic surgery.

Curly toes are present at birth and affect the third, fourth and fifth toes of one or both of a child’s feet. It is caused by the tightening of the tendon that runs below the toe, resulting in pulling of the tip of the toe under the next toe toward the sole. If your child has curly toes, he may develop areas of hard skin on the soles of his feet and may have difficulty finding shoes that fit properly.

Your child’s doctor will do a physical exam.

Generally, no treatment is needed if curly toes don’t cause any symptoms. But if the condition becomes severe and causes irritation, pediatric orthopedic surgery may be performed.

Polydactyly is a condition in which there is an extra digit on the foot. The great toe (big toe) or fifth toe (little toe) is usually affected. Polydactyly may occur alongside other congenital (present at birth) anomalies or as an isolated problem. It is often a hereditary condition, and many times one or both parents may have also had extra fingers or toes at birth.

Polydactyly can be seen in an ultrasound before a child is born and at birth. Your child’s doctor will order an X-ray and perform a physical exam to determine the best course of treatment.

If the extra toe doesn’t cause any problems, it may go untreated. Surgical excision of the extra toe will be done if there is an extra little or big toe that is prominent, causing difficulty for your child to wear shoes. If required, pediatric orthopedic surgery is usually performed when your child is 6 to 12 months old.

Syndactyly is the presence of fused digits and may be an isolated condition or occur along with other congenital (present at birth) anomalies. The connection between two or more toes varies from a thin skin attachment to a bony attachment (synostosis) between the bones in the toes.

Syndactyly may be seen in an ultrasound before a child is born and at birth. Your child’s doctor will order an X-ray and perform a physical exam to determine the best course of treatment, if needed.

This toe condition rarely causes any problems and often does not need treatment.

Bunionette is a less common condition and happens at the joint where your child’s fifth (little) toe meets his foot. It is a fluid sac over the outer side of the little toe joint that becomes swollen and inflamed, causing pain.

A doctor will examine your child’s foot. An X-ray will be ordered in rare cases.

Your child could try wearing wider shoes or putting a bunionette pad over the area to help relieve discomfort and pain. Oral medications like ibuprofen can also help relieve pain and inflammation, and placing an ice pack on the bunionette has been proven to do the same. In some cases, orthotics may be recommended. Pediatric orthopedic surgery may be required if the pain continues.

Hallux valgus, commonly known as a bunion, is a bump at the base of the big toe that can cause painful irritation and inflammation. Bunions can occur in young teenagers and are especially common in girls ages 10 to 15. While bunions in older women are typically associated with wearing high-heeled shoes with narrow toes, that is typically not the case in children and teens. Children with bunions usually have flat feet and may have loose tendons in the feet, both of which can lead to bunions.

In most cases, bunions can be diagnosed with an X-ray and physical exam.

Bunions may cause pain and trouble wearing shoes. Shoes that have a wide toe box and are made of soft materials can help relieve symptoms. Other types of orthotics, splints and bunion straps can also help relieve pain.

Bunion surgery is not recommended unless your child is experiencing extreme pain and other treatments, like wearing wider shoes, don’t help. Bunions may also come back after surgery as your child’s feet grow. And although bunion surgery is done on a same-day basis with no hospital stay, a long recovery is common and may include persistent swelling and stiffness.

Many of our orthopedic doctors subspecialize in congenital (present at birth) foot deformities and other pediatric foot conditions and injuries. They are common and range from normal differences that need no treatment to severe deformities that need prompt and intensive treatment.

We treat the following pediatric foot conditions and injuries:

An accessory navicular is an extra bone or piece of cartilage that is present on the inner center arch of your child’s foot. It is a congenital (present at birth) condition.

Your child will have a physical exam and be asked whether the condition is causing any irritation or swelling. An X-ray may be ordered to help confirm the diagnosis.

Treatment for accessory navicular may include:

  • Immobilizing your child’s foot with a cast or removable walking boot to help reduce inflammation.
  • Icing the area to help reduce swelling. Try an ice cup massage. Fill a plastic foam cup with water and freeze it. When frozen, peel an inch of the plastic foam from the bottom of the cup, and apply an ice massage directly to the injured area for 10 to 15 minutes. This can be repeated every 60 to 90 minutes.
  • Taking nonsteroidal anti-inflammatory medications to help reduce pain and inflammation.
  • Participating in physical therapy to help strengthen the muscles and reduce inflammation.
  • Wearing orthotics to support your child’s arch and possibly help prevent future issues.
  • Undergoing pediatric orthopedic surgery if nonsurgical treatments fail. This will involve removing the accessory navicular to improve function.

Calcaneovalgus foot is a condition in infants in which the foot is pushed up against the front of the leg. It’s caused by a baby being crowded or growing in an unusual position in the womb and can go along with other problems, including hip dysplasia and muscular torticollis in the neck. Due to the association with hip dysplasia, infants with calcaneovalgus foot should have their hips examined by a pediatric orthopedic surgeon.

Calcaneovalgus foot can be diagnosed by your child’s doctor, who will perform a complete medical history, physical exam and visual evaluation.

A calcaneovalgus foot that is flexible will almost always improve on its own with time. Gentle stretching, such as during diaper changes, may help improve the condition. Most babies’ feet will look normal within one to two months. In rare, more severe cases, a series of casts may be required.

A calcaneovalgus foot that is rigid may mean a more serious foot problem and should be evaluated early on by a pediatric orthopedic specialist.

If your child was recently diagnosed with a calcaneovalgus foot deformity, schedule an appointment so we can make sure that your child’s feet are flexible and that the neck and hips appear normal as well.

Clubfoot is a congenital (present at birth) foot condition that causes a child’s foot to be twisted inward. The cause of clubfoot is unknown and may look painful, but it does not cause any discomfort to babies.

Learn more about clubfoot.

Congenital vertical talus (CVT) is an uncommon foot deformity diagnosed at birth that gives the foot a “rocker-bottom” appearance. It affects the talus, which is a bone in the foot that sits between the tibia (shinbone) and heel and helps transfer weight from the lower part of the leg onto the foot. The cause of CVT is unknown, but about 50% of children with this condition will have other associated disorders, such as arthrogryposis, spina bifida or chromosomal disorders. And although CVT is not painful during early childhood, treatment is recommended to prevent pain, loss of function and trouble with wearing shoes in the future.

CVT may be seen in an ultrasound before a child is born and at birth. Your child’s doctor will order an X-ray to determine the best course of treatment, if needed.

Early treatment of CVT by a pediatric orthopedic surgeon is recommended. Our specialists at Children’s successfully treat CVT in younger children with a treatment similar to the Ponseti method used to treat clubfoot. Treatment includes stretches and a series of casts, followed by a limited surgical procedure. The goal of treatment is to provide a functional, stable, pain-free foot throughout your child’s life. Unless CVT is associated with another condition that limits function, children with corrected congenital vertical talus can run, play and wear normal shoes in the future.

Flatfoot is a condition in which the entire sole of your child’s foot touches the floor when he is standing. There are two types of flatfoot:

  • Flexible flatfoot: This common condition presents itself when your child’s arch disappears when standing but reappears when sitting or on his tiptoes. Many children with flexible flatfeet will eventually outgrow the condition—and for those children who do not outgrow it, most will never have any pain or problems with activities like walking or running.
  • Rigid flatfoot: A less common form of flatfoot, rigid flatfoot differs in that the arch of your child’s foot does not reappear when he is sitting or on his tiptoes. Several abnormalities in the joints of the hindfoot can lead to a rigid flatfoot.

In some children, there may be aching pain in the bottom of the foot, especially during adolescence. If this is the case, an evaluation by a pediatric orthopedic specialist is recommended.

Treatment for a painful flatfoot is required only when there is discomfort. Some common recommended treatment options include:

A cavus deformity of the foot, most commonly known as a high arch, is an elevated arch in the foot. While there may be no underlying cause, high arches are often the result of an underlying neurological condition, including:

  • Peripheral neuropathies, like Charcot-Marie-Tooth disease
  • Central neurological conditions, like cerebral palsy or Friedreich ataxia
  • Spine abnormalities, like tethered cord syndrome
  • Diastematomyelia
  • Syringomyelia
  • Spina bifida

Children who develop a high arch should be evaluated by a pediatric orthopedic specialist. A referral to a pediatric neurologist may also be made to look for an underlying neurological cause, if one is not already known.

While most cases of a cavus deformity require pediatric orthopedic surgery for correction, nonsurgical treatments like supportive orthotics may help some patients. High arches in children that have an underlying progressive neurological condition may recur after surgery, and additional surgery may be required.

Commonly referred to as pigeon toes, intoeing happens when children walk with their feet turned in. It’s a pretty common foot condition that can be congenital (present at birth) or may develop as a child ages.

Learn more about intoeing.

In children, there is an area on the heel bone where the bone grows. This is called the growth plate, or apophysis. Sever’s disease, also called calcaneal apophysitis, is the most common cause of heel pain in children, teenagers and young adults. It may be caused by an overuse injury, your child wearing shoes with poor heel padding or arch support, or running and jumping.

A physical examination will include checking for tenderness on the bottom of your child’s heel. Your child’s doctor may order an X-ray to be sure there is no damage to the growth plate.

It is very important that your child always wear shoes with padded heel surfaces and good arch support. Your child’s doctor may recommend shoe inserts called orthotics, which can be purchased at a pharmacy or athletic shoe store. They can also be custom made.

If pain persists, your child may need to rest or stop activities that cause heel pain for three to four days, or until the pain goes away. A doctor may also prescribe anti-inflammatory medication.

The goal of treating Sever’s disease is for your child to return to his sport or activity as soon as it is safe. If your child returns too soon, the injury may worsen and lead to permanent damage. Your child’s return to activities will be determined by how soon your child’s heel recovers, not by how many days or weeks it has been since the injury happened. In general, the longer your child has symptoms before starting treatment, the longer it will take to get better.

Sever’s disease is best prevented by having your child wear shoes that fit properly. The heel portion of the shoe should not be too tight, and there should be good padding in the heel.

Some children simply get too much physical activity, such as playing on too many teams or practicing for hours. Heel pain may be a message from your child’s body, asking him to slow down. If your child is experiencing heel pain, we’re here to help.

Tarsal coalition is a congenital (present at birth) condition that happens when the bones of the hindfoot fail to separate from each other in early development, so there is an abnormal connection. It sometimes runs in families.

Since the bones in early childhood are primarily made of cartilage, coalitions are soft early on and often go unnoticed. As the cartilage gradually turns into bone, coalitions become stiffer and are more prone to injury with activity. Typically, children will not have a noticeable problem until late childhood or adolescence. Tarsal coalitions can cause activity-related foot pain, stiffness or recurrent ankle sprains.

While any bones in the hindfoot can have a coalition, the two most common types of tarsal coalition are located between the calcaneus and navicular bones and between the calcaneus and talus bones.

A physical examination will include checking your child’s foot and ankle. An X-ray may be ordered to confirm the diagnosis.

About 50% of children with tarsal coalition have coalitions in both feet. Initial treatment is aimed at reducing symptoms. Simply decreasing sports activities for a couple of weeks can sometimes help, although this is not always necessary if symptoms are mild. Over-the-counter anti-inflammatory medication (ibuprofen or naproxen) and icing can also reduce symptoms. If initial treatment is unsuccessful, custom shoe inserts (orthotics) or a trial of walking cast immobilization can sometimes help. Pediatric orthopedic surgery may be needed if other treatments fail and symptoms persist.

The tarsal tunnel is the gap formed between the underlying bones of the foot and the overlying tough fibrous tissue. Tarsal tunnel syndrome refers to a condition in which the posterior tibial nerve that lies within the tarsal tunnel is compressed or pinched. Most children with tarsal tunnel syndrome complain of pain, numbness, and a burning or tingling sensation on the bottom of the foot and heel.

The exact cause of tarsal tunnel syndrome is unknown, but certain conditions can increase the risk, including:

  • Fractures
  • Bone spurs
  • Ganglions
  • Benign tumors
  • Muscle impingement
  • Foot deformities

Other medical conditions, such as arthritis, can also cause swelling in the joints that can compress the nerve. Scar tissue formed after an ankle injury and growth of abnormal blood vessels can also press against the nerve, resulting in compression.

Tarsal tunnel syndrome can be diagnosed by a Tinel’s test, which is performed by tapping the posterior tibial nerve lightly. This causes pain and other symptoms, indicating tarsal tunnel syndrome.

Tarsal tunnel syndrome may be treated with:

  • Nonsteroidal anti-inflammatory medications to relieve pain and reduce swelling
  • Corticosteroid injections into the area around the nerve to decrease the swelling
  • Orthotics, such as specially designed shoe inserts or footwear, to help support the arch of the foot and take tension off the tibial nerve

If conservative measures are ineffective, a pediatric orthopedic surgeon may perform tarsal tunnel release surgery to treat the condition. During this surgery, an incision is made in the tarsal tunnel, and pressure on the tibial nerve is released.

Toe walking is when a child walks on his tiptoes instead of placing his heels down to step forward. Children toe walk at times when they first learn to walk. Most children outgrow toe walking by 2 years old.

If your child toe walks after age 2, talk with his doctor. Your child may need to be checked to find out if there are any problems causing it, such as an orthopedic or neurological condition.

Treatment may include one or more of the following:

  • Physical therapy exercises to stretch and strengthen muscles.
  • Serial casting if muscles in the lower leg (calf) are tight. This helps stretch muscles and joints by using a series of casts on the leg.
  • Leg braces, such as an ankle-foot orthosis, that keep heels down when walking.
  • Night splints, which are a type of brace that is worn at night to keep muscles stretched.
  • Botulinum toxin type A injection, which is a shot that is given to relax tight muscles.
  • Pediatric orthopedic surgery to cut part of the muscle that is too tight if other treatments do not help.

From ankle fractures to ankle sprains, ankle injuries are among the most common bone and joint injuries and can affect your child’s tibia (shinbone), fibula (outer ankle bone) and talus (bone that connects the leg to the foot).

The pediatric orthopedic specialists at Children’s are trained to treat a range of pediatric ankle conditions and injuries, including:

Ankle sprains are injuries to a ligament and a common sports injury. Nearly half of all ankle sprains occur in children and teens. Most ankle sprains happen when a child’s ankle turns toward the outside, or “rolls over.” Pain may be felt immediately, and swelling could happen within hours. The degree of swelling depends on the severity of the sprain and how quickly it’s treated.

Ankle sprains are graded as mild, moderate or severe (or 1, 2 and 3):

  • Grade 1: stretched but minimally torn ligament fibers
  • Grade 2: partial ligament tear
  • Grade 3: complete ligament tear

Your child will need a physical exam by his doctor in order to determine whether he has an ankle sprain. An X-ray is not necessary to confirm the diagnosis.

Luckily, sprains can be treated at home with:

  • Rest: Immediately remove your child from an activity, whether he is in a game, at practice or playing with friends. Continuing play will worsen ligament damage and increase the severity of the injury. Do not remove your child’s shoe until ice can be applied—a tight shoe will act as a compression wrap and limit the initial swelling.
  • Ice: Apply crushed or chipped ice in a plastic bag directly over the skin for 20 minutes, every one to two hours. Another method is to try an ice cup massage. Fill a plastic foam cup with water and freeze it. When frozen, peel an inch of the plastic foam from the bottom of the cup, and apply an ice massage directly to the injured area for 10 to 15 minutes. This can be repeated every 60 to 90 minutes.
  • Compression: Tightly wrap the ankle with a first aid elastic bandage, starting at the toes and going up around the foot to the ankle. Do not allow skin to show. You may also use a stirrup brace for support and compression.
  • Elevation: Keep your child’s ankle elevated above the level of his heart.
  • Medication: Give your child acetaminophen (Tylenol) as needed for the first two to three days to help relieve pain.
  • Rehabilitation: Begin range-of-motion exercises the next day to prevent stiffness during the first phase of healing. While your child is seated, have him imagine that his big toe is a pen, and have him trace all the capital letters in the alphabet as large as possible. This can be done three times in the air or in a large bucket of ice water (keep the foot in the bucket for five to seven minutes). Once your child has done the exercise, reapply a compression wrap and elevate his ankle.

You should have your child evaluated by a doctor if:

  • There is immediate or severe swelling.
  • Your child cannot put weight on his ankle.
  • There is pain in the bones below the knee.
  • The treatments above don’t result in improvement within five to seven days.

Your child may return to competition or resume normal physical activities when:

  • Most of the swelling is gone.
  • He has full range of motion.
  • His strength is 90% or better than the uninjured side.
  • He can balance on the injured ankle.
  • He can perform the tasks required of his sport (sprinting, cutting or jumping) with no pain, swelling or a limp.

Recovery time will depend on the grade of your child’s ankle sprain:

  • Grade 1: two to three weeks
  • Grade 2: four to six weeks
  • Grade 3: 10 to 12 weeks

Returning to play is best determined by function (range of motion, strength and balance) and not by time. The above time frames should only serve as a guide.

A physical therapist with experience in sports injuries and rehabilitation can help in all phases of your child’s recovery. Athletes with ankle sprains who see sports physical therapists can return to their sports sooner and stronger and have less of a chance of re-spraining their ankles. Once the initial pain and swelling is under control, a sports physical therapist can develop a customized program to improve range of motion, flexibility, strength and balance. When your child is ready to return to play, the therapist can also offer guidance on using bracing, ankle supports or ankle taping.

The best predictor of future ankle sprains is a past ankle sprain. Untreated ankle sprains or insufficient physical therapy may result in chronic ankle instability. Recognizing an injury and rehabilitating it appropriately are critical for a young athlete’s muscle and bone health.

The Achilles tendon is the large tendon that connects the calf muscles to the heel bone and is used to walk, run and jump. The bursa—a fluid-filled sac located at the back of the heel under the Achilles tendon—contains a lubricating fluid that acts as a cushion to reduce friction between the muscles and bones. Retrocalcaneal bursitis is a painful condition caused by swelling of the bursa and overuse of the ankle as a result of too much walking, jumping or running, as well as some ballet positions.

A doctor will look at the skin on the back of your child’s heel to see if it has become warm and red. The doctor will also squeeze the space between the tendon and heel bone to see whether it causes pain. An X-ray will be done to rule out any other causes of heel pain, such as an ankle fracture.

Treating retrocalcaneal bursitis may include:

  • Restricting activities that cause your child pain.
  • Applying ice on the injured area, which will help to reduce the swelling. Try an ice cup massage. Fill a plastic foam cup with water and freeze it. When frozen, peel an inch of the plastic foam from the bottom of the cup, and apply an ice massage directly to the injured area for 10 to 15 minutes. This can be repeated every 60 to 90 minutes.
  • Giving your child nonsteroidal anti-inflammatory medications to help reduce inflammation and pain.
  • Wearing custom heel wedges (orthotics) to help reduce stress on the heel.
  • Scheduling an appointment with a sports physical therapist, who can help restore and improve the flexibility and strength of the muscles, tendons and joints around your child’s ankle.
  • Immobilizing the ankle for several weeks if the doctor diagnoses your child with retrocalcaneal bursitis. This can be done by casting the ankle, which limits movement and allows the tendon to rest.
  • Undergoing pediatric orthopedic surgery only when all nonsurgical treatments fail to help your child’s pain and inflammation. There is a procedure known as a bursectomy in which a doctor can remove the inflamed or infected bursa.

Retrocalcaneal bursitis can be prevented by helping make sure your child warms up properly before and stretches appropriately after any sports activity.

A broken ankle is a fracture or fractures of three bones in the ankle joint, which can render your child’s ankle unstable. This injury is usually caused by the ankle twisting, turning or rolling while walking or running.

Our team at Children’s helps diagnose and treat the following ankle fractures:

A distal (bottom) fibula fracture occurs on the outer portion of the ankle and often involves the growth plate of the small fibula bone. In children, the bone’s growth areas are made of cartilage and weaker than the bone or surrounding ligaments, making ankle fractures a common childhood injury. Thankfully, they heal easily without much lasting impact. On occasion, and in more severe fractures, the growth plate can be affected and stop growing.

There are two types of distal fibula fractures:

  1. Nondisplaced: The fractured bone fragments are aligned (can look like an ankle sprain, but with mild swelling and pain when your child stands or attempts to walks).
  2. Displaced: The fractured bone fragments are misaligned or separated.

A doctor will first examine your child’s ankle. An X-ray may be ordered but may only show subtle signs of the fracture.

Typically, a child is placed in a walking boot or short walking cast for several weeks. When the cast is removed, the bone is usually healed, and your child will be ready for activities as soon as his strength and range of motion improve. Sports physical therapy is sometimes recommended based on the severity of the injury and activity level of your child.

Children and teens can often twist an ankle by rolling it, resulting in a Tillaux fracture (pronounced till-oh). This is a fracture that goes through the joint and growth plate. It is most common in children between 12 and 14 years old, as the growth plate is beginning to close. Symptoms of a Tillaux fracture may include severe pain in the ankle, difficulty bearing weight on the injured ankle, limping, swelling and bruising.

In a Tillaux fracture, the injury to the growth plate disrupts the ankle joint. Failure to properly and promptly treat this growth plate injury can lead to a deformed joint and early arthritis. These fractures can be misdiagnosed as an ankle sprain. The cause of injury and appearance are similar.

Tillaux fractures are not always visible on an X-ray because a large part of the fracture goes through the growth plate, which is still cartilage. Our pediatric-trained radiologists and orthopedic specialists can identify this kind of fracture through imaging, patient history and a physical examination.

Treatment of a Tillaux fracture depends on the extent of the injury. Minor cases can be handled with a closed reduction in which the doctor places the ankle in the proper position and then casts it. If the fracture is displaced (separated), pediatric orthopedic surgery is necessary. The procedure involves placing a screw across the fracture site to help properly align the ankle joint.

A triplane fracture usually happens when a teenager is doing some type of twisting maneuver. It is also commonly called a transitional fracture since it only happens in adolescents during the period of time when the growth plate of the distal tibia bone is closing.

After a physical examination, your child’s doctor may order a CT scan along with an X-ray. These can help a physician determine the exact fracture pattern and degree of injury.

If the bones are not separated from each other, the fracture can likely be treated with a cast. The cast, however, is often a long cast above the knee and will be worn for three to four weeks, followed by a short cast for two to four weeks, making the total cast time six to eight weeks.

If the bones are displaced (separated), pediatric orthopedic surgery may be recommended so the bone can heal in a straight position. After surgery, your child may have to wear a short cast for four to six weeks.

After triplane fractures, sports physical therapy is often recommended to help your child regain ankle strength and range of motion. And since there is a risk of permanent injury to the growth area, your child will need a follow-up visit at least one year after the injury to help make sure the ankle continues to grow straight.

This content is general information and is not specific medical advice. Always consult with a doctor or healthcare provider if you have any questions or concerns about the health of a child. In case of an urgent concern or emergency, call 911 or go to the nearest emergency department right away. Some physicians and affiliated healthcare professionals on the Children’s Healthcare of Atlanta team are independent providers and are not our employees.