gms | German Medical Science

Objectives: In children and adolescents, fractures of the calcaneus are rare and the health-related quality (HRQoL) of life after this injury is unknown. We aimed to evaluate the HRQoL in children and adolescents with a fracture of the calcaneus and to assess if HRQoL was associated with radiological fracture classification.

Methods: We followed up on 32 children and adolescents who sustained a fracture of the calcaneus treated at our institution from 2004 to 2019. Radiographs were classified according to Schmidt. Patients filled in a questionnaire including the FAAM (Foot and Ankle Ability Measure), and the Peds-QL (Pediatric Quality of Life Inventory).

Results: Of the 32 patients with a fracture of the calcaneus, there were 13 with additional injures. Of the 19 children with isolated injuries, nine patients had an unilateral fracture (mean age 9.5 years) and ten patients (mean age 8.9 years) had bilateral fractures of the calcaneus. In the 19 patients with isolated injuries, the most common fracture type was joint depression (56%), followed by the avulsion (17%), and the liner fracture involving the subtalar joint (11%). The tongue type, the fracture of the sustentaculum tali and fracture of the anterior process occurred in 6%. Most cases (65%) were treated non-operatively. After a mean follow-up of 6.3 years, the mean FAAM Score was 98.8, the mean PedsQL-PF (physical function) was 97.9 and the mean PedsQL-PS (psychosocial function) was 88.9. For the FAAM and the PedsQL-PF, inferior outcome was strongly associated with joint depression type fractures.

Conclusions: HRQoL, as measured by the FAAM and the PedsQL after fractures of the calcaneus in children and adolescents was good to excellent. Inferior outcomes was strongly associated with joint depression type fractures. This indicates that special care should be taken if joint depression type calcaneal fractures are treated in children.