Display options
Share it on

Orthop Rev (Pavia). 2013 Jun 19;5(2):82-5. doi: 10.4081/or.2013.e17. Print 2013 Jun 07.

Pediatric and adolescent intra-articular fractures of the calcaneus.

Orthopedic reviews

Marcel Dudda, Christiane Kruppa, Jan Geßmann, Dominik Seybold, Thomas A Schildhauer

Affiliations

  1. Department of Surgery, University Hospital Bergmannsheil, Ruhr-University of Bochum , Germany.

PMID: 23888207 PMCID: PMC3718241 DOI: 10.4081/or.2013.e17

Abstract

Calcaneal fractures in childhood are very rare, whereas particularly intra-articular displaced fractures are not typical in skeletally immature children. Various techniques of osteosynthesis have been described. This study aimed to determine clinical and radiological outcome after surgical treatment of intraarticular calcaneal fractures. Fourteen intraarticular fractures of the calcaneus were included in this retrospective study. Eleven children (2 girls and 9 boys) aged 6-16 years (average age 11.5 years) underwent surgical treatment. One child sustained a Type II open fracture of both calcanei. All injuries occurred after a high-energy trauma; 3 patients had multiple additional fractures. The clinical and radiological postoperative follow up was an average 44 months. In 4 cases, a reduction through a minimally invasive approach and fixation with K-wires or screws could be achieved. Eleven fractures were treated with open reduction and internal fixation with plate osteosynthesis, K-wires or screws. In one case with open fractures of both heel bones, an additional external fixator was applied. The surgical treatment approach adopted enabled the pre-operative Böhler's angle (average 16°) to be improved to an average 30°. In all cases, except for the patient with open fractures, a good functional result and outcome could be achieved. In calcaneal fractures in childhood, anatomical reduction is the determining factor, as in fractures in adults, whereas the surgical technique seems to have no influence on clinical outcome in children. The wound healing problems that have often been described were not observed in this age group.

Keywords: calcaneal fracture; intra-articular fracture; osteosynthesis; pediatric fracture

References

  1. Injury. 2003 Jun;34(6):454-9 - PubMed
  2. J Pediatr Orthop. 1998 Jul-Aug;18(4):469-74 - PubMed
  3. Injury. 1993 Mar;24(3):169-70 - PubMed
  4. Arch Orthop Trauma Surg. 1987;106(2):129-31 - PubMed
  5. J Orthop Trauma. 1992;6(2):252-65 - PubMed
  6. J Pediatr Orthop. 2004 Mar-Apr;24(2):178-80 - PubMed
  7. Br J Surg. 1969 Sep;56(9):664-6 - PubMed
  8. Unfallchirurg. 2005 Jul;108(7):601-3 - PubMed
  9. J Pediatr Orthop. 2010 Dec;30(8):888-92 - PubMed
  10. Acta Orthop Scand. 1988 Oct;59(5):560-3 - PubMed
  11. Pediatr Radiol. 2006 Jul;36(7):670-6 - PubMed
  12. Foot Ankle Int. 2001 Jun;22(6):471-7 - PubMed
  13. Peptides. 1990 Nov-Dec;11(6):1103-8 - PubMed
  14. Zentralbl Chir. 2003 Jun;128(6):517-28 - PubMed
  15. Clin Orthop Relat Res. 2005 Mar;(432):107-15 - PubMed
  16. J Pediatr Orthop. 1996 Mar-Apr;16(2):201-5 - PubMed
  17. Eur J Radiol. 2001 Feb;37(2):123-9 - PubMed
  18. Clin Orthop Relat Res. 1993 May;(290):87-95 - PubMed
  19. Unfallchirurg. 2007 Nov;110(11):939-45 - PubMed
  20. Surg Radiol Anat. 2011 Sep;33(7):623-30 - PubMed
  21. Br J Surg. 1952 Mar;39(157):395-419 - PubMed
  22. J Orthop Trauma. 1988;2(2):154-7 - PubMed
  23. Pediatr Radiol. 1984;14(1):37-40 - PubMed
  24. S Afr Med J. 1989 Jul 15;76(2):53-4 - PubMed
  25. J Bone Joint Surg Br. 2000 Mar;82(2):211-6 - PubMed
  26. Arch Orthop Trauma Surg. 1998;118(1-2):111-2 - PubMed
  27. J Bone Joint Surg Am. 1973 Jul;55(5):1091-4 - PubMed
  28. J Pediatr Orthop B. 1997 Apr;6(2):79-83 - PubMed
  29. Clin Orthop Relat Res. 1982 Nov-Dec;(171):150-5 - PubMed
  30. Clin Orthop Relat Res. 1984 Sep;(188):131-8 - PubMed
  31. Acta Orthop Scand. 1987 Oct;58(5):507-9 - PubMed

Publication Types