Imai Yuuki, Kitano Toshio, Nakagawa Keisuke, Takaoka Kunio
Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi, Abenoku, Osaka 5458585, Japan.
Arch Orthop Trauma Surg. 2007 Jul;127(5):331-3. doi: 10.1007/s00402-007-0297-8. Epub 2007 Mar 21.
Isolated fracture of the calcaneal apophysis is a rare injury in children and adolescents. In this study, we report on a case of a displaced calcaneal apophyseal avulsion fracture in a child treated with open reduction and internal fixation, as well as a review of the literature. A 9-year-old female child presented to the senior surgeon complaining of acute heel pain after a gymnastic injury. She was diagnosed with a displaced, isolated fracture of the proximal calcaneal apophysis for which she underwent open reduction and internal fixation. On the magnetic resonance imaging (MRI) examination, we could diagnose that her injury was not chronic but acute because there was no change of intensity in the metaphyseal area. A combination of bioabsorbable suture tacks and pins was used to anatomically fix the fragment using the tension band wiring technique. At 2 years and 6 months follow-up, she had full range of motion, complete return of strength. We report here on the successful surgical treatment and the first case evaluated by MRI of an avulsion fracture of the calcaneal apophysis in a child.
跟骨骨骺孤立性骨折在儿童和青少年中是一种罕见的损伤。在本研究中，我们报告了一例儿童移位性跟骨骨骺撕脱骨折，采用切开复位内固定治疗，并对相关文献进行了综述。一名9岁女童因体操损伤后出现急性足跟疼痛，就诊于资深外科医生。她被诊断为近端跟骨骨骺移位性孤立骨折，并接受了切开复位内固定治疗。在磁共振成像（MRI）检查中，我们能够诊断出她的损伤不是慢性的而是急性的，因为干骺端区域没有强度变化。使用生物可吸收缝线钉和钢针的组合，采用张力带钢丝技术对骨折块进行解剖固定。在随访2年6个月时，她的活动范围完全恢复，力量也完全恢复。我们在此报告儿童跟骨骨骺撕脱骨折成功的手术治疗以及首例通过MRI评估的病例。
