Congenital dysplasia of the heel fat pad: a case report of a previously undescribed entity.

We describe a 13-year-old girl who was born with a congenital anomaly of her left heel fat pad. We call this anomaly congenital dysplasia of the heel pad, due to under development of all elements of the heel fat pad. In the case presented the vertical fibrous septa were missing and the amount of fat and its distribution were abnormal. As a result, the abnormal biomechanical shock absorber mechanism caused a painful callosity formation. A surgical procedure aiming to produce adhesions between the fat pad and the calcaneous in order to decrease the shear of the heel pad was only partially successful. Different types of orthotic devices did not resolve the clinical problem of the painful heel. Such a congenital anomaly has never been described in the English literature, and we coined the term congenital dysplasia for the previously undescribed entity.