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An atypical calcaneal fracture in a child: a literature review concerning the treatment.

Guterres LW, Ribeiro DA, Ribeiro TA - J Clin Med Res (2014)

Bottom Line: Significantly hind-foot reduced range of motion associated with a lateral/plantar calcaneal swelling and pain was found.After 4 weeks, no pain and limping was reported by the child's parents.Patient had no complaints of pain, no restrictions in range of motion and normal walking.

View Article: PubMed Central - PubMed

Affiliation: Servico de Ortopedia e Traumatologia do Hospital Universitario de Santa Maria (SOT-HUSM), Universidade Federal de Santa Maria (UFSM), Santa Maria, Rio Grande do Sul (RS), Brazil.

ABSTRACT
Calcaneal fractures are considered uncommon accounting for 0.005-0.41% of all children fractures. Few reports concerning treatment are available. Most of these fractures are non-displaced/minimally displaced and are associated with a fall of less than 1 m. The aim of this case report was to discuss the diagnosis and treatment of a child calcaneal fracture, an atypical presentation despite the high energy mechanism of trauma. A 7-year-old child fell from a 5-m ladder with all his weight on his right heel. Significantly hind-foot reduced range of motion associated with a lateral/plantar calcaneal swelling and pain was found. Neurovascular examination and other parts of the body were normal. Radiograph showed an undisplaced calcaneal body fracture and computed tomography confirmed no subtalar joint involvement. A splint followed by plaster was applied. Weight bearing and deambulation were not allowed. After 4 weeks, no pain and limping was reported by the child's parents. Plaster was removed and radiograph showed fracture consolidation. Patient had no complaints of pain, no restrictions in range of motion and normal walking. Limping in children is a difficult complaint to assess. Differential diagnoses of a calcaneal fractures should be performed, even without a history of trauma or a history of trivial trauma.

No MeSH data available.


Related in: MedlinePlus

Computed tomography images demonstrate: (A, B) axial slices showing the end of the subtalar joint; (C-F) sequential axial slices from proximal to distal showing the fracture of the calcaneal body and not showing articular fracture.
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Figure 2: Computed tomography images demonstrate: (A, B) axial slices showing the end of the subtalar joint; (C-F) sequential axial slices from proximal to distal showing the fracture of the calcaneal body and not showing articular fracture.

Mentions: Radiographic examination (Fig. 1) showed in an axial view an undisplaced calcaneal body fracture. An ankle splint was applied with the foot maintained in a neutral position (90° of flexion). In order to exclude the involvement of the subtalar joint, an elective computed tomography (CT) was solicited. One week after injury, the parents followed the child for review. No complaint was referred by the patient and the CT was evaluated (Fig. 2). No subtalar joint involvement was found and an extra-articular calcaneal body fracture was confirmed. The splint was replaced by a plaster. Weight bearing and deambulation were not allowed to the patient.


An atypical calcaneal fracture in a child: a literature review concerning the treatment.

Guterres LW, Ribeiro DA, Ribeiro TA - J Clin Med Res (2014)

Computed tomography images demonstrate: (A, B) axial slices showing the end of the subtalar joint; (C-F) sequential axial slices from proximal to distal showing the fracture of the calcaneal body and not showing articular fracture.
© Copyright Policy - open access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4217755&req=5

Figure 2: Computed tomography images demonstrate: (A, B) axial slices showing the end of the subtalar joint; (C-F) sequential axial slices from proximal to distal showing the fracture of the calcaneal body and not showing articular fracture.
Mentions: Radiographic examination (Fig. 1) showed in an axial view an undisplaced calcaneal body fracture. An ankle splint was applied with the foot maintained in a neutral position (90° of flexion). In order to exclude the involvement of the subtalar joint, an elective computed tomography (CT) was solicited. One week after injury, the parents followed the child for review. No complaint was referred by the patient and the CT was evaluated (Fig. 2). No subtalar joint involvement was found and an extra-articular calcaneal body fracture was confirmed. The splint was replaced by a plaster. Weight bearing and deambulation were not allowed to the patient.

Bottom Line: Significantly hind-foot reduced range of motion associated with a lateral/plantar calcaneal swelling and pain was found.After 4 weeks, no pain and limping was reported by the child's parents.Patient had no complaints of pain, no restrictions in range of motion and normal walking.

View Article: PubMed Central - PubMed

Affiliation: Servico de Ortopedia e Traumatologia do Hospital Universitario de Santa Maria (SOT-HUSM), Universidade Federal de Santa Maria (UFSM), Santa Maria, Rio Grande do Sul (RS), Brazil.

ABSTRACT
Calcaneal fractures are considered uncommon accounting for 0.005-0.41% of all children fractures. Few reports concerning treatment are available. Most of these fractures are non-displaced/minimally displaced and are associated with a fall of less than 1 m. The aim of this case report was to discuss the diagnosis and treatment of a child calcaneal fracture, an atypical presentation despite the high energy mechanism of trauma. A 7-year-old child fell from a 5-m ladder with all his weight on his right heel. Significantly hind-foot reduced range of motion associated with a lateral/plantar calcaneal swelling and pain was found. Neurovascular examination and other parts of the body were normal. Radiograph showed an undisplaced calcaneal body fracture and computed tomography confirmed no subtalar joint involvement. A splint followed by plaster was applied. Weight bearing and deambulation were not allowed. After 4 weeks, no pain and limping was reported by the child's parents. Plaster was removed and radiograph showed fracture consolidation. Patient had no complaints of pain, no restrictions in range of motion and normal walking. Limping in children is a difficult complaint to assess. Differential diagnoses of a calcaneal fractures should be performed, even without a history of trauma or a history of trivial trauma.

No MeSH data available.


Related in: MedlinePlus