Foot and ankle trauma in children

Specialty: Children's Orthopaedic
Age group: Children

Criteria for referral to public hospital service

• Suspected or confirmed Lisfranc injury
• Nondisplaced or minimally displaced fractures of the distal tibia, fibula, tarsal bones or metatarsals (excluding the fifth metatarsal)
• Displaced articular fractures of the phalanges
• Osteochondral fracture of the talar dome
• Suspected or confirmed injuries to the syndesmosis
• Achilles tendon rupture.

Information to be included in the referral

Information that must be provided

• Reason for referral and expectation or outcome, anticipated by the child, or their carer, and the referring clinician from referral to the health service
• Date, mechanism, severity, recurrence and evolution of injury
• Details of any previous surgery including when and where procedures were performed
• Findings on physical examination including loss of range of movement and neurological examination
• How the ankle or foot has been immobilised (cast, backslab, CAM boot) and instructions on weight bearing provided
• Pain history: onset, location, nature of pain and duration
• If ankle injury x-ray of the affected foot anteroposterior (AP) view, mortise view and lateral view
• If foot injury x-ray of the affected foot anteroposterior (AP) view, oblique view and lateral view.

Provide if available

• Statement about the parent(s) or guardian’s interest in having surgical treatment if that is a possible intervention
• If the child is neurodiverse, gender diverse or has a disability
• If the child identifies as an Aboriginal and/or Torres Strait Islander
• If the child has a preferred language other than English and if they rely on cultural or linguistic support (e.g. Aboriginal cultural support, an interpreter)
• If the child lives in out-of-home care (foster care, kinship care, permanent care or residential care)
• If younger than 18 years if they may have been harmed, or at risk of harm
• If the child is aged 14 to 18 years, do they consent that their health information is shared with their parent, guardian or carer.

Additional comments

The Minimum information for referrals to non-admitted specialist services lists the information that should be included in a referral request.

Where appropriate and available the referral may be directed to an alternative specialist clinic or service.

Referral to a public hospital is not appropriate for

• Ankle sprains
• Small avulsion fractures of the fibula or tarsal with no other bone or joint injury.