A rare case report of intra-articular calcaneal fracture in pediatric patient

Abstract text (incl. references and figure legends)

Calcaneal fractures are rare in children and frequently missed injuries.The type of fracture varies with patient age and falls are the most common mechanism of injury.
The majority of the fractures can be treated with a period of immobilization and a period of protected weight-bearing and have a favorable prognosis in the pediatric population.

A 8-year-old male patient was brought to the Emergency Department after a fall from 1 meter of height.The patient was unable to ambulate and reported left calcaneal pain.After the general examination,a swelling and bruising at the level of the left heel accompanied by pain and functional impotence for mobilization of the ankle are highlighted.Mobility, sensitivity and distal vascular conserved.
After a complete imagiological study (X-ray and CT),an intraarticular left calcaneal fracture with a Böhler angle of 30º and a Gissane angle of 139º was diagnosed, type 5B of the classification of pediatric calcaneal fractures.
After evaluating the case,conservative treatment was decided.The patient remained immobilized 6 weeks with suropedic splint ,discharge for 2 weeks and subsequent rehabilitation.During the periodical controls, a satisfactory radiological evolution with preservation of the subtalar joints and the Böhler angle was observed.At one year of follow-up, the asymptomatic patient has a normal life with complete joint mobility.No obvious deformity or precise use of plantar orthosis for walking.

The choice of treatment is unanimous in the case of non-displaced fractures,choosing an orthopedic treatment with immobilization and discharge.However,there is controversy among the displaced fractures.Some authors defend the non-surgical posture given the bone remodeling capacity.Nonetheless,other authors defend the anatomical reduction, especially in children older than 10 years

The lack of studies with long-term follow-up and the possibility of performing both treatments make that surgeons can choose one of these options.

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