Abstract

Introduction: Aneurysmal Bone Cyst is a benign reactive bone lesion filled with multiple blood-filled cavities, locally destructive and expansile lesion. The incidence of Aneurysmal Bone Cyst in tarsal bone is less than 12% of which calcaneum account for about 1.6% of all Aneurysmal Bone Cysts. Here, we report a case of Aneurysmal Bone Cyst of calcaneum which is one of the rarest sites.

Case report: A 10-year-old boy presented with a 3-month history of pain and swelling in right heel, He had previous history of trivial fall and underwent 3 native bandages. On examination he was found to have bony hard swelling from the calcaneum. X-ray and computed tomography were suggestive of an expansile lytic lesion with sclerotic borders with internal septations. Differential diagnosis of Giant Cell Tumour and Aneurysmal Bone Cyst were made. Extended curettage with fibular strut graft augmented with synthetic bone graft substitute (Modified Hydroxyapatite blocks) was done. Histopathology suggestive of Aneurysmal Bone Cyst. Outcome was measured using AOFAS ankle hind foot score.

Discussion: Aneurysmal bone cyst of calcaneum though very rare site of occurrence, should be considered as one of the differential diagnosis for patients with heel pain. Due to inadequate autogenous bone graft, synthetic bone graft substitute was used to fill the defect in paediatric age group. Patient was made to weight bear at 6 weeks and good graft uptake was seen on 3 months postoperatively. At 2 years follow up patient is pain free with excellent AOFAS Ankle hind foot score. To conclude Aneurysmal bone cyst of calcaneum is rare site of its occurrence and for paediatric age group surgical curettage augmented with Fibular strut grafting with bone graft substitute is a valid treatment option.