Foot fractures (other than metatarsal or phalangeal) in children
- Kathy Boutis, MD, FRCPC, FAAP, MSc
Kathy Boutis, MD, FRCPC, FAAP, MSc
- Associate Professor of Pediatrics
- University of Toronto
- Section Editor
- Richard G Bachur, MD
Richard G Bachur, MD
- Section Editor — Pediatric Trauma
- Professor of Pediatrics and Emergency Medicine
- Harvard Medical School
- Deputy Editor
- James F Wiley, II, MD, MPH
James F Wiley, II, MD, MPH
- Senior Deputy Editor — Adult and Pediatric Emergency Medicine
- Senior Deputy Editor — Primary Care Sports Medicine (Adolescents and Adults)
- Clinical Professor of Pediatrics and Emergency Medicine/Traumatology
- University of Connecticut School of Medicine
This topic will discuss the management of mid- and hindfoot fractures in children. Metatarsal and toe fractures in children and foot fractures in adults are discussed separately. (See "Metatarsal and toe fractures in children" and "Metatarsal shaft fractures" and "Toe fractures in adults" and "Sesamoid fractures of the foot".)
Although forefoot fractures (metatarsal and toe fractures) account for the majority of pediatric foot fractures, midfoot, and hindfoot fractures have the greatest potential for causing permanent deformity and disability [1,2].
Among these less common foot fractures, talar neck fractures are seen most frequently. Fractures of the calcaneus, cuboid, navicular, cuneiform, or tarsometatarsal (Lisfranc) region are rare [3-5]. However, as more children and adolescents have become users of motorized recreational vehicles (eg, mini scooters, motorized dirt bikes, all terrain vehicles, snowmobiles) or have participated in snowboarding, the frequency and severity of these foot injuries has increased [1,6].
The foot is divided into three regions (figure 1A-C):
●Forefoot – Metatarsal and phalangeal bones
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- CLINICAL ANATOMY
- MECHANISM OF INJURY
- CLINICAL PRESENTATION AND EXAMINATION
- Physical examination
- RADIOGRAPHIC DIAGNOSIS
- Plain radiographs
- Computed tomography
- Magnetic resonance imaging
- INITIAL MANAGEMENT
- Emergency conditions
- Analgesia and initial care
- INDICATIONS FOR ORTHOPEDIC CONSULTATION OR REFERRAL
- DEFINITIVE TREATMENT
- Talar fractures
- Calcaneal fractures
- Midfoot fractures
- Tarsometatarsal (Lisfranc) fractures
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS