The main concern is not growth arrest, but rather the stability of the articular surface itself. That should lead you to assume (correctly) that these fractures generally need to be stabilized in the OR. More on that in a minute (of your reading time).

Management

As you can see from the initial X-Ray the initial findings are not 100% obvious in many cases. However it is still important to get them first (after applying the Ottawa ankle rules of course) as is a high level of association with concomitant fibula fractures. Normal ankle X-Rays show the ‘telephone’ sign, where the tibia and fibula (the handset) sit above the talus (the telephone base).