Immediate:

• Immobilise in above-knee cast.
• Perform cast with analgesia, as good dorsiflexion of the ankle will optimise position.
• Post-cast XR
• If the intra-articular physeal fracture line remains visible on the post-cast XR, then perform CT
• Depending on CT, the patient may require operative vs. non-operative treatment

Definitive, non-operative:

• Above-knee cast for 3 weeks
• Convert to below-knee cast for a further 3 weeks
• Fracture clinic follow-up with XROA at 1 and 3 weeks

Definitive, operative:

• Open reduction and internal fixation