Introduction: Heel pad injuries can have devastating and debilitating consequences. All efforts to primarily reapproximate the heel pad should be undertaken. Reconstruction of the heel pad can often require multiple complex surgeries including microvascular flaps and tissue transfers. There is a paucity of successful techniques for primary repair in the literature. Case Presentation: In this case report, we describe the successful use of polydioxanone suture with sterile buttons for the repair of the heel pad in a pediatric patient. An 8-year-old male was struck by a vehicle, sustaining a full-thickness heel pad avulsion injury measuring approximately 16-cm in length. The soft tissue was sharply debrided and repaired primarily to the calcaneal periosteum using #1 polydioxanone suture with external suture buttons, and an incisional wound VAC was applied. He was placed into a long-leg bent knee cast and kept non-weight bearing for a total of 6 weeks, at which time the suture and buttons were removed and he was progressed to weight bearing as tolerated in a walking boot. At the 6-month follow-up examination, the heel pad was viable and well-fixed; the patient reported no pain and was not limited in any chosen activities. Conclusion: This construct was shown to provide effective fixation while mitigating reported concerns of tissue necrosis caused by suture repair. At 1 year from injury, the patient’s mother noted a slight limp with running but not with walking. He reported no pain at any time, and his Oxford Ankle-Foot Questionnaire for Children score was 58, indicating excellent patient-reported outcome following his procedures.

Atraumatic avulsion of the tibial attachment of patellar tendon in adults is a very rare injury with only few published case reports. Here we are sharing the successful management and follow-up of a similar case with a different suture material for repair of the tendon, the FiberWire. We believe that the management we are discussing allows for early return to activity with good functional outcome.

Septic arthritis due to Candida species is a relatively rare infection typically seen in patients with immunocompromising conditions. While C. albicans is the most commonly encountered fungal species affecting humans, C. tropicalis has demonstrated increasing resistance to anti-fungal medications leading to persistent and difficult to control infections [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15]. C. tropicalis is part of the normal human microbiota and is typically found on the skin and mucosal surfaces of the body. It is the third most common Non-Candida albicans Candida species (NCAC) isolated in clinical practice and primarily found in tropical regions, particularly Asia and South America [1,8]. Few reports of Tropicalis septic arthritis in North America have been published. We present a case report of a confirmed monoarticular C. tropicalis septic arthritis in a pediatric patient with chemotherapy induced granulocytopenia the setting of relapsed acute myeloid leukemia that lead to systemic candidiasis and patient mortality. Case ReportOur patient is a 13-year-old Caucasian female who presented to our institution with relapsed AML following bone marrow transplant with clinical signs and symptoms concerning for graft vs. host disease. She had undergone previous chemotherapy treatment a little over a month prior to her admission and had an indwelling catheter. The patient was scheduled for intrathecal chemotherapy administration and was undergoing preoperative evaluation when it was noticed she had a diffuse rash and endorsing febrile episodes as well as diffuse joint pain. Pre-operative labs showed of white count of 0.1 cells/mm 3 as well as elevated inflammatory markers. She was admitted to our Children's hospital for further work up and evaluation. 2