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Child Foot And Ankle Injuries: When Is It Time To Call The Doctor?

Foot and ankle injuries are quite common among children, the majority of which occur due to sports activity, games, or falls. Although most minor injuries can be treated at home, some foot and ankle injuries may necessitate the attention of a paediatric orthopaedic doctor. Here is an overview of the most common kinds of foot injuries in children, their causes, symptoms, and when you should seek medical advice. 

 

Common Foot and Ankle Injuries in Children

Ankle injuries are typically classified according to the type of affected tissue, such as a tendon, muscle, ligament, or bone. The following are the most common foot and ankle injuries in children:

 

  1. Ankle Sprains: The human ankle is made up of three bones (tibia, fibula, and talus) that are held together by elastic tissues known as ligaments. When these ligaments get injured due to rapid movement or twists, it results in an ankle sprain. Due to the overstretching of the ligaments, tears and bleeding around the ankle joint occur. Usually, children get ankle sprains while running, jumping, or participating in sports such as basketball or football.

 

Common signs and symptoms of ankle sprains are:

  • Swelling (develops within a few minutes or some hours)
  • Pain around the ankle joint
  • Bruising (appears within 2-3 days)

 

  1. Strains: Ankle strains refer to overstretched or torn muscles. Unlike ankle sprains, which are generally acute injuries, ankle strains can be acute or chronic. Acute ankle strains result from a single traumatic event, such as overexertion or a lack of sufficient warm-up. Chronic ankle strain, on the other hand, is caused by long-term overuse of the ankle muscles. While minor ankle strains can be managed at home, severe ankle strains require immediate medical attention, as they can lead to persistent discomfort and deformity.

The following are some of the most typical indications and symptoms of an ankle strain:

  • Pain (appears immediately in case of acute strains)
  • Swelling at the strain site
  • Redness
  • Inflammation
  • Muscle spasms, weakness, and cramps
  • Limited ankle movement

 

  1. Sever’s Disease: Also known as calcaneal apophysitis, Sever’s disease is common among growing children (8–14 yrs). It causes heel pain that worsens when children engage in high-impact activities that exert pressure on the heel. Though painful, Sever’s disease is not a serious condition and goes away within a few months.

Signs and symptoms of Sever’s disease are:

  • Stiffness in the feet
  • Swelling, redness, and irritation in the heel
  • Limping or walking on tiptoes
  • Heel pain
  • Tenderness and pain that worsens with activities and improves after rest
  1. Ankle Fracture: Ankle fractures are another common ankle injury in children. In kids and adolescents, ankle fractures can develop in any of the three bones that make up the ankle and usually involve the growth plates (areas of cartilage that become hard with age). It usually happens during sports when children roll or twist their ankles on an uneven surface, are struck by an object directly, or change directions too rapidly or forcefully. Overuse might also result in a broken ankle. Although home treatments can be used to repair minor fractures, complex fractures may require surgery.

Symptoms of ankle fractures are:

  • Pain and swelling in the affected area
  • Inability to stand or walk
  • Bruising
  • Tenderness to the touch
  • Deformity of the ankle area
  1. Other Injuries:
  • Puncture Wounds: Puncture wounds are caused by sharp objects like nails, needles, ice picks, and so on. These wounds may appear small and insignificant, but if left untreated, they increase the risk of infection because dirt and hazardous germs from socks and shoes can easily enter the wound and result in further complications.
  • Compartment Syndrome: Compartment syndrome is an orthopaedic emergency that develops when the muscles, nerves, blood vessels, and bones do not have enough capacity to grow due to swelling in an enclosed area. If not treated immediately, the pressure imposed on arteries, veins, and nerves causes excruciating pain, decreases circulation to the muscles and nerves, and may cause lasting damage to these tissues.
  • Dislocation: An ankle dislocation occurs when a powerful force pushes an ankle bone out of place. Allowing the bone to remain dislocated for an extended period may result in severe injury.  Therefore, it is advisable to seek a paediatric orthopaedic doctor as soon as possible to fix the dislocation. 

 

When to seek a doctor?

Most foot and ankle injuries can be treated at home by following the RICE (rest, ice, compression, and elevation) strategy, as well as practising some ankle exercises. However, regardless of the injury, treatment must begin within a few days so that the condition does not worsen. If the pain is not severe, the ankle has a full range of motion, and there is no misalignment, you don't need to rush to the doctor.

 

You should consult a doctor when:

  • Even after receiving home care, the signs and symptoms of the foot and ankle injury do not heal within a day or two.
  • If your child is unable to stand or put weight on the wounded ankle, seek medical help immediately.
  • Your child experiences pain when the ankle bones are pressed (high tenderness). 
  • There is a lot of swelling and soreness that would not go away with rest.
  • The injured ankle has become discoloured. 
  • The skin has tears and openings in it.
  • There is a bone misalignment, puncture wound, fracture, or compartment syndrome.

 

If necessary, the paediatric orthopaedic doctor will use x-ray or higher imaging to diagnose the problem and may propose the use of a splint, brace, cast, or boot. If the damage is significant, surgery could also become necessary. 

 

The Paediatrics specialty at Medanta not only provides comprehensive care for all types of paediatric injuries, but also ensures that you and your child receive a caring and compassionate environment throughout the treatment. For effective and personalised care for your child, consult the highly qualified team of Medanta's paediatric experts here.  

 

Dr. Ashok Rajgopal
Orthopaedics
Meet The Doctor
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