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Calcaneal fractures in children

LONG-TERM RESULTS OF TREATMENT

Division of Orthopaedic Surgery, University of Ottawa, Ottawa Hospital, General Site, 501 Smyth Road, Ottawa, Ontario, Canada K1H 8L6.

Correspondence should be sent to Dr J. A. Brunet at 206-1929 Russell Road, Ottawa, Ontario, Canada K1G 4G3.

The late results of treatment of calcaneal fractures in 17 children (19 fractures) were reviewed at a mean of 16.8 years after injury. With the exception of one patient, all fractures had been treated conservatively. At follow-up there were few complaints. All but two patients had full or slightly reduced mobility of the subtalar joint and unrestricted foot function, including the ability to walk comfortably on uneven surfaces. Minor radiological abnormalities of the hindfoot were common; there were two cases of post-traumatic osteoarthritis. Clinical scoring of the ankle and hindfoot using the American Orthopaedic Foot and Ankle Society rating system averaged 96.2 points.

The results suggest that up to 16.8 years after injury almost all children achieve excellent long-term functional results with conservative treatment of fractures of the os calcis. Open management may only be appropriate for adolescents with severe displacements.