Abstract
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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Aksoy B, Ozturk K, Ensenyel CZ, Kara AN (1998) Avulsion of the iliac crest apophysis. Int J Sports Med 19:76–78
Alvarez Fernandez JL, Villalba Vaquero M, Gomez Cimiano J (1989) Epiphysiolysis of the great tuberosity of the calcaneum: brief report. J Bone Joint Surg Br 71:321
Birtwistle SJ, Jacobs L (1995) An avulsion fracture of the calcaneal apophysis in a young gymnast. Injury 26:409–410
Lazovic D, Wegner U, Peters G, Gosse F (1996) Ultrasound for diagnosis of apophyseal injuries. Knee Surg Sports Traumatol Arthrosc 3:234–237
Liberson A, Lieberson S, Mendes DG, Shajrawi I, Ben Haim Y, Boss JH (1995) Remodeling of the calcaneus apophysis in the growing child. J Pediatr Orthop B 4:74–79
Mayba II (1982) Avulsion fracture of the tibial tubercle apophysis with avulsion of patellar ligament. J Pediatr Orthop 2:303–305
Muscato M, Lim-Dunham J, Demos TC, Lomasney LM (2001) Avulsion fracture of the apophysis of the ischial tuberosity. Orthopedics 24:1127, 98–200
Ogden JA, Ganey TM, Hill JD, Jaakkola JI (2004) Sever’s injury: a stress fracture of the immature calcaneal metaphysis. J Pediatr Orthop 24:488–492
Rosenberg N, Noiman M, Edelson G (1996) Avulsion fractures of the anterior superior iliac spine in adolescents. J Orthop Trauma 10:440–443
Walling AK, Grogan DP, Carty CT, Ogden JA (1990) Fractures of the calcaneal apophysis. J Orthop Trauma 4:349–355
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Imai, Y., Kitano, T., Nakagawa, K. et al. Calcaneal apophyseal avulsion fracture. Arch Orthop Trauma Surg 127, 331–333 (2007). https://doi.org/10.1007/s00402-007-0297-8
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DOI: https://doi.org/10.1007/s00402-007-0297-8