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Editorial
January 4, 2016

Revisiting Radiograph-Negative Ankle Injuries in Children: Is It a Fracture or a Sprain?

Author Affiliations
  • 1Department of Paediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
  • 2Children’s Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, Manitoba, Canada
  • 3Department of Pediatrics and Child Health, College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
JAMA Pediatr. 2016;170(1):e154147. doi:10.1001/jamapediatrics.2015.4147

In this issue of JAMA Pediatrics, Boutis and colleagues1 determine the true rate of Salter-Harris I growth plate fractures of the distal fibula (SH1DF) among children with ankle injuries. Ankle injuries are common in children, leading to more than 2 million emergency department (ED) visits in Canada and the United States each year.1,2 Most ankle injuries are minor—85% due to forced inversion—and clinical decision rules help guide the need for radiography.3 Clinicians worry about missing a potential growth plate fracture, which could result in growth arrest, although the likelihood of growth arrest is rare.4

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