Os calcis fracture patterns in ten children (mean age 12. 8) with eleven fractures were classified using plain films and CT scans and found to be similar to those in adults.

All except two of the fractures (which were not significantly displaced) were treated with open reduction and internal fixation. In all cases it was possible to achieve anatomic reduction and rigid internal fixation. Eight patients had ‘excellent’ long-term clinical results.

One patient with a court case pending scored ‘good’, and one patient with an ipsilateral talar neck fracture scored ‘fair’. This patient had mildly limited ankle movement; all others had full ankle movement. Six had full subtalar movement, in 2 it was mildly limited and in three it was moderately limited (50–80%). There was no evidence of abnormality of the physes on follow up x-rays. We conclude that operative treatment of these fractures yields optimal results.