# Arthroscopic-Assisted Pediatric Transitional Ankle Fracture Reduction and Fixation Technique

## TL;DR

This paper introduces a new arthroscopic technique for treating ankle fractures in children, showing excellent healing and recovery outcomes.

## Contribution

The novel contribution is an arthroscopic-assisted fixation technique for transitional ankle fractures in pediatric patients.

## Key findings

- Three pediatric patients showed excellent functional outcomes with average FAOS and AAOS scores of 92 and 93 at six months.
- The average time to full weight-bearing was 45 days, and radiological healing occurred at 57 days.
- The technique uses standard instruments and offers precise reduction with minimal complications.

## Abstract

This paper describes and evaluates an arthroscopic technique for arthroscopic reduction and fixation (ARIF) of transitional ankle fractures, presenting its preliminary clinical outcomes.

This is a retrospective technical report on prospectively collected data from patients who underwent ARIF of transitional ankle fractures. Demographic information, along with clinical details such as injury type, duration of surgery, length of hospital stay, and maximum Visual Analog Scale (VAS) pain scores, were prospectively collected. Postoperatively, patients were followed up for a minimum of one year, where complications, time to achieve full weight bearing, and radiological evidence of fracture healing were all documented. Functional outcomes were also evaluated using the average Foot and Ankle Outcome Score (FAOS) and the American Academy of Orthopedic Surgeons (AAOS) score at six-month follow-up. Clinical outcomes were assessed to evaluate the effectiveness of this ARIF technique.

Three patients, two (67%) females and one (33%) male, with a mean age of 13 ± 1 years, underwent the arthroscopically assisted fixation method for low-energy fractures, including two (67%) Tillaux fractures and one (33%) two-part triplane fracture. The average duration of surgery was 93 ± 7 minutes. Postoperatively, the maximum VAS pain score recorded was 4 ± 1 during hospitalization, and all patients were discharged the following day. The average time to full weight-bearing was 45 ± 6 days, while radiological healing occurred on average at 57 ± 7 days. At the six-month follow-up, the average FAOS was 92 ± 5, and the AAOS score was 93 ± 3. Functional outcomes were excellent and may surpass those of previously reported ARIF techniques.

In conclusion, the arthroscopically assisted fixation technique described in this study for Tillaux and two-part triplane fractures has yielded outstanding clinical outcomes, demonstrating excellent healing and functional recovery. By offering a safer, more controlled means of achieving precise fracture reduction, it enhances surgical efficiency without compromising workflow. Moreover, its reproducibility and reliance on standard surgical instruments make it a practical and accessible option for widespread adoption across varied clinical settings.