Epiphysiolysis of the great tuberosity of the calcaneum: brief report

Isolated fracture of the calcaneal apophysis is a rare injury in children and adolescents. In this study, we report on a case of a displaced calcaneal apophyseal avulsion fracture in a child treated with open reduction and internal fixation, as well as a review of the literature. A 9-year-old female child presented to the senior surgeon complaining of acute heel pain after a gymnastic injury. She was diagnosed with a displaced, isolated fracture of the proximal calcaneal apophysis for which she underwent open reduction and internal fixation. On the magnetic resonance imaging (MRI) examination, we could diagnose that her injury was not chronic but acute because there was no change of intensity in the metaphyseal area. A combination of bioabsorbable suture tacks and pins was used to anatomically fix the fragment using the tension band wiring technique. At 2 years and 6 months follow-up, she had full range of motion, complete return of strength. We report here on the successful surgical treatment and the first case evaluated by MRI of an avulsion fracture of the calcaneal apophysis in a child.

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Demographics of extra-articular calcaneal fractures: including a review of the literature on treatment and outcome

Schepers

Ginai

Lieshout

et al. 2007

Arch Orthop Trauma Surg

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Introduction Extra-articular calcaneal fractures represent 25-40% of all calcaneal fractures and an even higher percentage of up to 60% is seen in children. A disproportionately small part of the literature on calcaneal fractures involves the extra-articular type. The aim of this study was to investigate the incidence of extra-articular calcaneal fractures in a Level 1 trauma centre, deWne the distribution of the various types of fractures and compare patient demographics between extra-and intra-articular calcaneal fractures. In addition the literature was reviewed for the most common types of extra-articular calcaneal fractures with regard to incidence, treatment and clinical outcome. Methods The radiological records between 2003 and 2005 were reviewed for intra-and extra-articular calcaneal fractures. Patient gender-distribution and age were compared. A literature search was conducted for the treatment of extra-articular calcaneal fractures. Results In this 3-year study period a total of 49 patients with 50 extra-articular calcaneal fractures and 91 patients with 101 intra-articular fractures were identiWed. The median age for the Wrst group was 32.7 years, and for the second group 40.3 years; P = 0.04. Male predominance was signiWcantly less pronounced for extra-articular (63%) compared with intra-articular fractures (79%; P = 0.04). ConclusionOne-third of all calcaneal fractures are extra-articular. SigniWcant diVerences exist between the intra-and extra-articular groups, in terms of lower age and male-female ratio. The literature study shows inconsistencies in treatment options, but most extra-articular fractures are well manageable conservatively.

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Epiphysiolysis of the great tuberosity of the calcaneum: brief report

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Calcaneal apophyseal avulsion fracture

Demographics of extra-articular calcaneal fractures: including a review of the literature on treatment and outcome

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