The Treatment of Complex Motorcycle Spoke Injuries in Children

Area of Science:

• Pediatric Orthopedics
• Trauma Surgery
• Reconstructive Surgery

Background:

• Motorcycle spoke injuries are rare but can cause significant soft tissue, Achilles tendon, and calcaneal defects in children.
• Treatment of calcaneal defects, especially with concurrent Achilles tendon and soft tissue involvement, remains challenging.
• The calcaneus is crucial for standing and gait, making effective treatment essential for maintaining patient quality of life and mobility.

Purpose of the Study:

• To report the effective treatment of complex calcaneal defects in pediatric patients resulting from motorcycle spoke injuries.
• To evaluate the efficacy of distraction osteogenesis with a novel external fixator framework for reconstructing the calcaneus.

Main Methods:

• Four children (ages 6-11) with Achilles tendon, soft tissue, and calcaneal defects underwent staged surgical reconstruction.
• Second-stage surgery addressed Achilles tendon and soft-tissue defects.
• Third-stage surgery involved osteotomy of the residual calcaneus, followed by lengthening using a customized external fixator at 1.5 mm/day and repositioning.

Main Results:

• All four pediatric patients achieved a calcaneal lengthening of 5 cm.
• The distraction osteogenesis technique successfully restored calcaneal length, width, and height.
• No complications were reported in the provided abstract.

Conclusions:

• Distraction osteogenesis utilizing an externally applied fixator framework is an effective treatment for pediatric calcaneal defects.
• This method offers a viable solution for restoring calcaneal anatomy and function in children with severe trauma-related defects.