Cover Journal of the American Podiatric Medical Association
Journal of the American Podiatric Medical Association
ISSN:
8750-7315
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Article Type:
Clinically Speaking
Online Publication Date:
Sep 2018

The Treatment of Complex Motorcycle Spoke Injuries in Children

A Report of Four Cases and Literature Review

Jiasharete Jielile Department of Microsurgical and Reconstruction of Orthopedics Centre, First Teaching Hospital of Xinjiang Medical University and Sports Medicine Research Centre of Orthopedics Research Institute, Urumqi, Xinjiang, China.

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Pengfei Li Department of Microsurgical and Reconstruction of Orthopedics Centre, First Teaching Hospital of Xinjiang Medical University and Sports Medicine Research Centre of Orthopedics Research Institute, Urumqi, Xinjiang, China.

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Wulan Bahetiya Department of Microsurgical and Reconstruction of Orthopedics Centre, First Teaching Hospital of Xinjiang Medical University and Sports Medicine Research Centre of Orthopedics Research Institute, Urumqi, Xinjiang, China.

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Aynaz Badelhan Department of Microsurgical and Reconstruction of Orthopedics Centre, First Teaching Hospital of Xinjiang Medical University and Sports Medicine Research Centre of Orthopedics Research Institute, Urumqi, Xinjiang, China.

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Bayixiati Qianman Department of Microsurgical and Reconstruction of Orthopedics Centre, First Teaching Hospital of Xinjiang Medical University and Sports Medicine Research Centre of Orthopedics Research Institute, Urumqi, Xinjiang, China.

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Ayidaer Jialihasi Department of Microsurgical and Reconstruction of Orthopedics Centre, First Teaching Hospital of Xinjiang Medical University and Sports Medicine Research Centre of Orthopedics Research Institute, Urumqi, Xinjiang, China.

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Nuerai Shawutali Department of Pediatric Surgery, Peoples' Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, China.

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Jianati Wuerliebieke Department of Microsurgical and Reconstruction of Orthopedics Centre, First Teaching Hospital of Xinjiang Medical University and Sports Medicine Research Centre of Orthopedics Research Institute, Urumqi, Xinjiang, China.

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Adili Aizezi Department of Microsurgical and Reconstruction of Orthopedics Centre, First Teaching Hospital of Xinjiang Medical University and Sports Medicine Research Centre of Orthopedics Research Institute, Urumqi, Xinjiang, China.

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Naertai Yeerboo Department of Microsurgical and Reconstruction of Orthopedics Centre, First Teaching Hospital of Xinjiang Medical University and Sports Medicine Research Centre of Orthopedics Research Institute, Urumqi, Xinjiang, China.

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Elihaer Makemutibieke Department of Microsurgical and Reconstruction of Orthopedics Centre, First Teaching Hospital of Xinjiang Medical University and Sports Medicine Research Centre of Orthopedics Research Institute, Urumqi, Xinjiang, China.

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Amuding Aisaiding Department of Microsurgical and Reconstruction of Orthopedics Centre, First Teaching Hospital of Xinjiang Medical University and Sports Medicine Research Centre of Orthopedics Research Institute, Urumqi, Xinjiang, China.

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Tuolihawu Hazehan People's Hospital of Tacheng City, Tacheng, China.

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Tulede Shatewalede Qingfeng Orthopedics Hospital of Urumqi, Urumqi, Xinjiang, China.

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Zhumatai Awuyyesihan People's Hospital of Aletai Area, Xinjiang, China.

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DOI:
https://doi.org/10.7547/16-066
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Motorcycle spoke injuries involving the soft tissue, Achilles tendon, and calcaneal defects are rare in children. Currently, calcaneal defects are very challenging to treat. Multiple methods have been used in clinical practice; however, an effective treatment has yet to be established, especially when Achilles tendon and soft-tissue defects are also present. It is important to address this condition, because the calcaneus plays a key role in standing and gait. Unsatisfactory treatment of calcaneal defects may significantly decrease patients' quality of life (eg, by limiting mobility). In this article, we report the effective treatment of calcaneal defects in four children using distraction osteogenesis with an external fixator framework designed by the authors. From May 2014 to May 2015, four children (age range, 6–11 years) with defects of the Achilles tendon, soft tissue, and calcaneus resulting from a motorcycle accident were treated at our hospital. The Achilles tendon and soft-tissue defects were treated with second-stage reconstruction. In the third-stage surgery, osteotomy of the residual calcaneus was performed. A customized external fixator was used to lengthen the calcaneus at a rate of 1.5 mm/day in the posterior direction and reposition it by 40° in the inferior direction. In all four children, the calcaneus was lengthened by 5 cm. Distraction osteogenesis through external fixation is effective for restoring the length, width, and height of the calcaneus in children.

Corresponding author: Jiasharete Jielile, MD, Department of Microsurgical and Reconstruction of Orthopedics Centre, First Teaching Hospital of Xinjiang Medical University and Sports Medicine Research Centre of Orthopedics Research Institute, Xinjiang, China. (E-mail: jingping-bai@163.com)
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