Calcaneal fractures in adolescents. CT classification and results of operative treatment.

The morphology of calcaneal fractures in 9 adolescents (mean age 13.4 years) with 10 fractures were classified using plain films and computed tomography scans. The patterns were found to be similar to those in adults. All except one of the fractures (which was not significantly displaced) were treated with open reduction and internal fixation. In all cases it was possible to achieve anatomic reduction and rigid internal fixation. Seven patients had 'excellent' long-term clinical results. One patient with pending litigation scored 'good', and one patient with an ipsilateral fracture of the talar neck scored 'fair'. This patient had mild limitation of ankle movement, all others had full ankle movement. Five had unrestricted subtalar movement, in two it was mildly limited and in three it was moderately limited (50-80%). There was no evidence of abnormality of the physes on follow up X-rays. We conclude that operative treatment of this fracture yields good results.