Calcaneus growth plate fracture in children

Pain, swelling, heel tenderness, or refusal to put the foot down after an injury should be evaluated. Treatment depends on the precise part of the developing bone involved and whether the fragments remain aligned.

A child's heel includes areas where bone is still maturing. An injury at or near this growth region can be difficult to distinguish from other causes of heel pain, and some fracture lines are subtle on initial images.

The clinician considers how the injury happened, where tenderness is greatest, the child's ability to bear weight, and the appearance of both bone and soft tissues. Imaging helps define alignment, but examination and follow-up remain important when symptoms continue.

Keep the child off painful activities and follow the team's weight-bearing directions. A splint, boot, or cast may be used to limit motion and shield the heel. Do not encourage walking through pain or remove prescribed support early because the child seems more comfortable.

Attend every planned review so the team can check comfort, skin, circulation, alignment, and return of function. Once protection is reduced, activity should advance in stages. Running, jumping, and playground impact wait until walking and prescribed movement are comfortable and the clinician has cleared progression.

Seek urgent assessment if the heel is visibly deformed, the skin is broken, pain or swelling rapidly worsens, or the child cannot move the toes. Toes that become numb, cold, pale, or blue may indicate pressure or circulation trouble. A cast or splint that becomes tight, soaked, broken, or causes burning pain also needs prompt review.

Ask exactly which part of the heel is injured, whether the fracture is displaced, and why the chosen support is appropriate. Confirm weight-bearing limits, cast care, follow-up imaging, signs of pressure, and the milestones for school, physical education, and sport. Also ask whether longer follow-up is advisable because the injury is near developing bone.