A Novel Technique for Calcaneal Avulsion Fracture: A Case Report

Abstract

Avulsion fractures of the calcaneal tuberosity constitute only a small percentage of calcaneal fractures. Avulsion fractures often occur in elderly women with osteoporosis. Various surgical methods are used in the treatment of this type of fracture. These include tension band wiring, suture anchor fixation, lag screw fixation, and TightRope® technique. In order to manage these fractures effectively, it is important to avoid skin necrosis and to ensure strong fixation that can resist the pull of triceps surae. We performed a novel technique using Achilles SpeedBridge™ and a cannulated lag screw. This technique allows for strong and easy fixation. A 57-year-old man presented to our department with a left ankle injury caused by slipping on a rocky area next to the sea. We diagnosed a type I calcaneal avulsion fracture, and planned surgical fixation. Surgery was performed 3 days after the injury. Postoperatively, the patient used a brace to maintain the ankle in the natural position for three weeks. Full weight bearing was started with Achilles boots after the brace was removed. His ankle range of motion was 30° plantar flexion and 60° dorsiflexion. He could perform all movements without any issues and without requiring support. His preoperative American Orhopaedic Foot and Ankle Society score was 52/100, and after 3 months this had increased to 100/100. We believe that this technique is highly effective for the treatment of type I calcaneal avulsion fractures.