Isolated avulsion fracture of the medial head of the gastrocnemius in a pediatric patient: A case report

Background: Isolated avulsion fractures of the medial head of the gastrocnemius muscle are rare, with limited documented cases, especially in pediatric patients. The scarcity of evidence contributes to a significant gap in understanding the injury's mechanism and optimal management. While opera...

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Main Authors: Stefan Ammann, Reto Twerenbold, Joel Locher
Format: Article
Language:English
Published: Elsevier 2025-08-01
Series:Journal of Orthopaedic Reports
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2773157X25000426
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author Stefan Ammann
Reto Twerenbold
Joel Locher
author_facet Stefan Ammann
Reto Twerenbold
Joel Locher
author_sort Stefan Ammann
collection DOAJ
description Background: Isolated avulsion fractures of the medial head of the gastrocnemius muscle are rare, with limited documented cases, especially in pediatric patients. The scarcity of evidence contributes to a significant gap in understanding the injury's mechanism and optimal management. While operative management is preferred in multiligamentary injuries, both operative and conservative approaches have been described in the case of isolated injuries. Case report: We present a case involving a 12-year-old girl with a slightly dislocated avulsion fracture of the medial head of the gastrocnemius sustained during recreational sports. The trauma mechanism involved knee flexion and a loaded knee with some rotational force. A conservative treatment strategy, including a temporary ban on sports activities and physiotherapy, led to a successful recovery, enabling the patient to return to recreational sports without pain at 10 weeks post-trauma. Conclusion: Isolated avulsion fractures of the medial head of the gastrocnemius, though rare, merit consideration, particularly in pediatric patients with a vulnerable bone component in the muscle–tendon–bone unit. Non-operative management, including activity limitation and physiotherapy, has demonstrated success in the pediatric population.
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spelling doaj-art-8bd56d62cb4747ccb7444e801c42e2752025-08-26T04:14:42ZengElsevierJournal of Orthopaedic Reports2773-157X2025-08-014210059010.1016/j.jorep.2025.100590Isolated avulsion fracture of the medial head of the gastrocnemius in a pediatric patient: A case reportStefan Ammann0Reto Twerenbold1Joel Locher2Department of Orthopedic Surgery and Traumatology, Zuger Kantonsspital, Landhausstrasse 11, 6340, Baar, SwitzerlandDepartment of Orthopedic Surgery and Traumatology, Zuger Kantonsspital, Landhausstrasse 11, 6340, Baar, SwitzerlandCorresponding author.; Department of Orthopedic Surgery and Traumatology, Zuger Kantonsspital, Landhausstrasse 11, 6340, Baar, SwitzerlandBackground: Isolated avulsion fractures of the medial head of the gastrocnemius muscle are rare, with limited documented cases, especially in pediatric patients. The scarcity of evidence contributes to a significant gap in understanding the injury's mechanism and optimal management. While operative management is preferred in multiligamentary injuries, both operative and conservative approaches have been described in the case of isolated injuries. Case report: We present a case involving a 12-year-old girl with a slightly dislocated avulsion fracture of the medial head of the gastrocnemius sustained during recreational sports. The trauma mechanism involved knee flexion and a loaded knee with some rotational force. A conservative treatment strategy, including a temporary ban on sports activities and physiotherapy, led to a successful recovery, enabling the patient to return to recreational sports without pain at 10 weeks post-trauma. Conclusion: Isolated avulsion fractures of the medial head of the gastrocnemius, though rare, merit consideration, particularly in pediatric patients with a vulnerable bone component in the muscle–tendon–bone unit. Non-operative management, including activity limitation and physiotherapy, has demonstrated success in the pediatric population.http://www.sciencedirect.com/science/article/pii/S2773157X25000426Isolated avulsion medial gastrocnemiusMedial gastrocnemius avulsionMedial head gastrocnemius injury
spellingShingle Stefan Ammann
Reto Twerenbold
Joel Locher
Isolated avulsion fracture of the medial head of the gastrocnemius in a pediatric patient: A case report
Journal of Orthopaedic Reports
Isolated avulsion medial gastrocnemius
Medial gastrocnemius avulsion
Medial head gastrocnemius injury
title Isolated avulsion fracture of the medial head of the gastrocnemius in a pediatric patient: A case report
title_full Isolated avulsion fracture of the medial head of the gastrocnemius in a pediatric patient: A case report
title_fullStr Isolated avulsion fracture of the medial head of the gastrocnemius in a pediatric patient: A case report
title_full_unstemmed Isolated avulsion fracture of the medial head of the gastrocnemius in a pediatric patient: A case report
title_short Isolated avulsion fracture of the medial head of the gastrocnemius in a pediatric patient: A case report
title_sort isolated avulsion fracture of the medial head of the gastrocnemius in a pediatric patient a case report
topic Isolated avulsion medial gastrocnemius
Medial gastrocnemius avulsion
Medial head gastrocnemius injury
url http://www.sciencedirect.com/science/article/pii/S2773157X25000426
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AT retotwerenbold isolatedavulsionfractureofthemedialheadofthegastrocnemiusinapediatricpatientacasereport
AT joellocher isolatedavulsionfractureofthemedialheadofthegastrocnemiusinapediatricpatientacasereport