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Pediatric calcaneal fractures.

S Mora1, D B Thordarson, L E Zionts

  • 1Department of Orthopaedics, Keck School of Medicine, University of Southern California, Los Angeles 90033, USA. docfish@email.com

Foot & Ankle International
|July 28, 2001
PubMed
Summary

Pediatric calcaneal fractures, though rare, show excellent outcomes with non-operative treatment. Immature bones remodel well, leading to good prognosis for these young patients.

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Area of Science:

  • Orthopedics
  • Pediatric Orthopedics
  • Traumatology

Background:

  • Calcaneal fractures are uncommon in pediatric patients.
  • These fractures occur before the distal tibial physis fusion.

Purpose of the Study:

  • To evaluate the outcomes of calcaneal fractures in skeletally immature patients.
  • To identify factors contributing to the prognosis of pediatric calcaneal fractures.

Main Methods:

  • Retrospective review of 22 skeletally immature patients (23 fractures).
  • Classification into intraarticular (78%) and extraarticular (22%) fractures.
  • Outcome assessment using a modified American Orthopaedic Foot and Ankle Society score after an average 4.4-year follow-up.

Main Results:

  • Seven of nine patients achieved pain-free status with unrestricted function and normal gait.
  • Two patients experienced activity-related and cold-weather pain.
  • Most fractures (8/9) were treated non-operatively with favorable results.

Conclusions:

  • Pediatric calcaneal fractures, both intraarticular and extraarticular, generally have an excellent prognosis.
  • Superior bone remodeling capacity in immature skeletons contributes to good outcomes.
  • Low-energy trauma and potentially unique fracture patterns in children may also play a role.

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