This is a review of 183 patients with 218 displaced intraarticular fractures of the calcaneus treated by open reduction and internal fixation. One hundred and ninety four (89%) wounds underwent primary uneventful healing. Twenty-four wounds (11%) required local wound care. One deep infection occurred in a neuropathic foot that required below-knee amputation. No free-tissue transfers, local tissue flaps or skin grafts were needed in patients who presented initially with a closed fracture. Ninety-five fractures (43.5%) required subsequent surgical procedures (hardware removal-88/95 [93% of secondary procedures]). Six patients (2.8%) had postoperative sural nerve findings. Seventeen procedures other than hardware removal were performed. There were five subtalar fusions including two subtalar distraction bone-block arthrodeses. There were seven claw toe correction procedures, four calcaneal valgus osteotomies for varus malunions and one subtalar arthrolysis at the time of hardware removal. These results suggest internal fixation of displaced intra-articular calcaneus fractures using a single lateral approach is a safe, reliable method of treatment.

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Flat foot (pes planus) is a progressive and disabling pathology that is treated initially with conservative measures and often followed by a variety of surgeries. This article briefly reviews the pathology in acquired flat foot deformity, the classification of posterior tibial tendon dysfunction, discusses surgical techniques for the management of adult flat foot deformity, and reviews potential complications and their relevant imaging appearances.

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