OCCULT FRACTURE OF THE CALCANEUS IN TODDLERS

Five children 14-33 months of age were treated for calcaneal fractures . All had a history of trauma with limping or refusal to walk. Physica l examination could not localize the fracture. Initial radiographs wer e negative. There were no signs of systemic illness. They were treated with long-leg casts. Radiographs after 2 weeks revealed an are of scl erosis across the tuberosity of the calcaneus. In no case was a bone s can instrumental in making the diagnosis. Awareness of calcaneal fract ures in the child younger than 36 months can prevent the routine use o f bone scans to make the diagnosis.