Late diagnosis of a McFarland fracture: imaging and treatment

McFarland fractures represent a type of oblique medial malleolar fracture in children that can be challenging to diagnose and treat. A 14-year-old junior league soccer player with a Salter Harris type IV McFarland fracture presented late, as the initial routine two views radiological assessment fail...

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Bibliographic Details
Published in:Skeletal radiology 2014, Vol.43 (1), p.65-69
Main Authors: Symeonidis, Panagiotis D., Konstantinidis, George Ath, Dionellis, Panagiotis S., Ousatzopoulos, John, Givisis, Panagiotis G.
Format: Article
Language:English
Subjects:
Adolescent
Ankle
Ankle Fractures
Case Report
Children
Delayed Diagnosis
Diagnostic imaging
Health aspects
Humans
Image Enhancement - methods
Imaging
Injuries
Magnetic Resonance Imaging - methods
Male
Medicine
Medicine & Public Health
Nuclear Medicine
Orthopedics
Pathology
Patient Positioning - methods
Radiology
Soccer - injuries
Soccer players
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Summary:McFarland fractures represent a type of oblique medial malleolar fracture in children that can be challenging to diagnose and treat. A 14-year-old junior league soccer player with a Salter Harris type IV McFarland fracture presented late, as the initial routine two views radiological assessment failed to reveal a clear fracture line. The addition of a mortise ankle view led to the correct diagnosis and subsequent MRI findings guided nonsurgical treatment with an excellent outcome. The debate between obtaining two or three views in closed pediatric ankle injuries according to the so-called Ottawa rules and the usefulness of magnetic resonance imaging (MRI) in the decision making for the choice of treatment of McFarland fractures are discussed in this case report.
ISSN:0364-2348
1432-2161
DOI:10.1007/s00256-013-1680-x