Avulsion Fracture of Calcaneal Apophysis in an Adolescent Gymnast : A Case Report

Youn Moo Heo; Whan Young Chung; Sang Bum Kim; Cheol Yong Park; Jin Woong Yi

doi:10.12671/jkfs.2009.22.4.288

Journal List > J Korean Fract Soc > v.22(4) > 1037718

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

Heo, Chung, Kim, Park, and Yi: Avulsion Fracture of Calcaneal Apophysis in an Adolescent Gymnast : A Case Report

Case Report

Journal of the Korean Fracture Society 2009; 22(4): 288-291.

Published online: 30 October 2009

DOI: https://doi.org/10.12671/jkfs.2009.22.4.288

Avulsion Fracture of Calcaneal Apophysis in an Adolescent Gymnast : A Case Report

Youn Moo Heo, M.D., Whan Young Chung, M.D., Sang Bum Kim, M.D., Cheol Yong Park, M.D., Jin Woong Yi, M.D.

Department of Orthopedic Surgery, Konyang University College of Medicine, Daejeon, Korea.

Address reprint requests to: Jin Woong Yi, M.D. Department of Orthopedic Surgery, Konyang University Hospital, 685, Gasuwon-dong, Seo-gu, Daejeon 302-241, Korea. Tel: 82-42-600-6902, 9120, Fax: 82-42-545-2373, woong@kyuh.co.kr

Received 27 March 2009 Accepted 23 July 2009

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The avulsion fracture of calcaneal apophysis by Achilles tendon in children is quite rare. It may occur with the injury of the apophysis on the calcaneal tuberosity in the children below the age of 12 to 15 before the union of the apophysis. The authors surgically treated a 14-year-old gymnast with the avulsion fracture of the calcaneal tuberosity who injured at the landing of the floor exercise. Radiographs at the fourteen months of follow-up showed slight irregularity of the calcaneal tuberosity but there were no pain or limitation of activity. We report a case with the review of literatures.

Keywords: Calcaneus, Apophysis, Avulsion fracture

Figures and Tables

Fig. 1

Preoperative lateral radiograph shows the avulsion fracture of calcaneal apophysis. The bony fragment is proximally displaced by Achilles tendon.

Fig. 2

(A) Immediate postoperative lateral radiograph shows anatomical reduction of bony fragment of calcaneal tuberosity and internal fixation with two K-wires.

(B) At 14 months after operation, soft tissue swelling and beak of proximal edge of calcaneal tuberosity are showed.

Fig. 3

Photograph with squatting and heel-rise position of ankle shows good functional results at 14 months follow-up.

References

1. Alvarez Fernandez JL, Villalba Vaquero M, Gomez Cimiano J. Epiphysiolysis of the great tuberosity of the calcaneum: brief report. J Bone Joint Surg Br. 1989; 71:321.

2. Birtwistle SJ, Jacobs L. An avulsion fracture of the calcaneal apophysis in a young gymnast. Injury. 1995; 26:409–410.

3. Brunner CF, Weber BG. Special techniques in internal fixation. 1st ed. Berlin: Springer-Verlag;1982.

4. Cole RJ, Brown HP, Stein RE, Pearce RG. Avulsion fracture of the tuberosity of the calcaneus in children. A report of four cases and review of the literature. J Bone Joint Surg Am. 1995; 77:1568–1571.

5. Imai Y, Kitano T, Nakagawa K, Takaoka K. Calcaneal apophyseal avulsion fracture. Arch Orthop Trauma Surg. 2007; 127:331–333.

6. Inokuchi S, Usami N, Hiraishi E, Hashimoto T. Calcaneal fracture in children. J Pediatr Orthop. 1998; 18:469–474.

7. Mooney V. Avulsion of the epiphysis of the os calcis. J Bone Joint Surg Am. 1935; 17:1056–1057.

8. Paley KJ, Milem CA, Ebraheim NA, Merritt TR. Severe displaced of a calcaneal apophyseal fracture. J Foot Ankle Surg. 1994; 33:180–183.

9. Park SJ, Choi NY, Chu IT, et al. Avulsion fracture of calcaneus in diabetic patients. J Korean Fract Soc. 2004; 17:173–176.

10. Schmidt TL, Weiner DS. Calcaneal fractures in children. An evaluation of the nature of the injury in 56 children. Clin Orthop Relat Res. 1982; 171:150–155.

TOOLS

Similar articles