Calcaneal Apophyseal Avulsion Fractures with Achilles Tendon Rupture in a 10-Year-Old Patient: A Case Report / 대한족부족관절학회지

Calcaneal apophysitis is a relatively common disease in young athletes. On the other hand, if not treated properly, it can lead to apophyseal avulsion fracture in rare cases. In the case of apophyseal avulsion fractures, it is often necessary to remove or preserve the bone fragment, which often requires a suture of the Achilles tendon. A 10-year-old badminton athlete visited the outpatients' clinic with pain in both heels from 10 months ago without any trauma history. After conservative therapy, the pain in the left heel was relived but the right heel pain persisted. After 10 months of conservative therapy, the patient visited the outpatients' clinic showing a calcaneal apophyseal avulsion fracture with a total rupture of the Achilles tendon. In the operation room, a bone fragment needed to be removed because of its poor viability and the fragment was too thin for fixation. After removing the bone fragment, the ruptured Achilles tendon was fixed with an anchor system.

Lesiones deportivas en niños y adolescentes / Pediatric and adolescent sports injuries

El aumento en la actividad deportiva de niños y adolescentes ha derivado en un aumento de las lesiones esqueléticas atribuidas a la actividad física. El aparato locomotor infantil presenta particularidades que hacen que los patrones de lesión difieran a lo que ocurre en los adultos. Se producen lesiones agudas y de sobrecarga que se presentan en edades y sitios específicos. Debido a la alta frecuencia de aparición de ellas, es necesario que los médicos que atienden niños estén familiarizados con los cuadros más frecuentes. En este artículo se revisan los aspectos más importantes de las principales lesiones deportivas en niños y adolescentes resumiendo las principales consideraciones diagnósticas, terapéuticas y pronósticas.

The increase in sport activity of children and adolescents has led to an increase in skeletal lesions attributed to physical activity. The children’s musculoskeletal system presents particularities that make injury patterns defer to those that occur in adults. Acute and overluse injuries are produced, which occur in specific locations and ages. Due to the high frequency of their occurrence, it is necessary that physicians who treat children are familiar with the most frequent conditions. In this article the most important aspects of major sports injuries in children and adolescents are reviewed by summarizing the main diagnostic, therapeutic and prognostic considerations.

Traction Apophysitis of Medial Malleolus: Two Cases report / 대한족부족관절학회지

9 and 10 years old boys presented with pain and swelling without history of trauma around medial malleolar right and left ankle. The swelling was diffuse with tenderness on anterior aspect of medial malleolus. The X-rays revealed fragmented accessory ossification center of medial malleolus an symptomatic side. Traction apophysitis was diagnosed because MRI revealed multiple foci of hypointensity in T1 and T2 weighted images of symptomatic medial malleolus apophysis. Patient was treated in conservative treatment by short leg cast for three or four weeks with restriction of sports activity and improved symptoms.

EVALUATION OF ELASTIC PROPERTIES OF ACHILLES TENDON AS A FACTOR OF APOPHYSITIS IN ELEMENTARY SCHOOL SOCCER CLUB MEMBERS / 体力科学

It is well known that extreme repetitive stress on the apophysis without considering the physical characteristics of children induces a growth disorder of the growing skeleton. However, only a few studies have evaluated the indexes of the muscle-tendon complex as a risk factor of apophysitis. The purpose of this study was to investigate the relationship between the elastic properties of the Achilles tendon, physical characteristics, muscle tightness (MT) and general joint laxity score (GLP), and tenderness from typical apophysitis (calcaneal tubercle, tibial tuberosity and iliac spine) in kindergarten and elementary school students. Body and lower leg size, and MT of the calf muscle increased ; while GLP decreased significantly with age. The Elastic index of the Achilles tendon and its standard deviations were greater among 5^th and 6^th graders than among 3^rd and 4^th graders. Point tenderness was more frequent in older age groups (4^th-6^th graders) than in younger age groups (kindergartren-3^rd graders) and was greatest in 4^th graders. When subjects were categorized into groups with and without point tenderness, no significant differences were found between GLP, muscle tightness of gastrocnemius, quadriceps and iliopsoas. However subjects who showed point tenderness had a higher Elastic index (p=0.07). Considering the pathomechanics of apophysitis, repetitive traction of the apophysis by a stiffer muscle-tendon unit lead to injury of the apophysis and growth plate. Tendon properties appear to be more sensitive to the pathomechanics of apophysitis.

Bilateral apophysitis of ischial tuberosity in a Taekwondo practitioner: A Case Report / 대한정형외과학회잡지

Ischial tuberosity pain in athletes may be caused by bony avulsions or apophysitis. Apophysitis of the ischial tuberosity is a rare condition observed in adolescents who participate in sports, it causes gradual increasing functional and palpable pain at the ischial tuberosity without any major trauma at the beginning of the symptoms. Bilateral apophysitis is very rare, and the reason that Taekwondo practitioners may develop it is due to stretching exercises of both lower extremities. Repeated traction can cause an apophysitis at 15-17 ages when the ossification process of the apophysis is ongoing. Conservative treatment is adequate for apophysitis. We report the clinical and radiologic findings in detail.