Physeal Stress Injuries of the Ankle and Foot

This chapter reviews the presentation, management, and prognosis of physeal stress injuries (PSIs) centered at the epiphyseal physes of the distal tibia and fibula, first and second metatarsals, and phalanges, as well as PSIs of apophyseal physes of the medial malleolus, calcaneus, and fifth metatarsal. Aside from the calcaneus, most PSIs in the ankle and foot are rare. These injuries are primarily treated conservatively with an excellent prognosis for return to play in young athletes, although there is a risk of premature physeal closure.