Calcaneal avulsion fractures: complications from delayed treatment

Novel Techniques in Treating Calcaneal Tuberosity Fractures

“…Hess et al reported on a case series of 3 patients with calcaneal tuberosity fractures who went on to have skin necrosis secondary to a delay in treatment. 8 In a large series of 139 tonguetype calcaneal fractures, Gardner et al reported that 21% had some degree of posterior soft tissue compromise with a higher incidence occurring in those patients who had greater fracture displace ment, a delay in seeking appropriate medical care or smoked tobacco.…”

Avulsion Fracture of the Calcaneal Tuberosity: A soft tissue complication from delayed treatment

“…For these reasons these fractures should be treated as emergencies with open reduction and internal fixation. 10 Methods of fixation include suturing of the avulsed bone fragment, suture anchors, tension band wiring and screw fixation as performed in the present case report. 6,7,9 The choice of technique depends on the size of the avulsed bone fragment and the degree of osteopenia.…”

“…10 The ankle initially assumes a position of maximal plantarflexion as in falling from a height. In this position the force from a loaded Achilles tendon is transmitted to the calcaneal tuberosity, and to the plantar fascia by a series of highly oriented trabeculae.…”

“…1,7,8,9 Most calcaneal fractures are closed injuries that are treated non-operatively, or if treated operatively, surgery is delayed to allow the soft tissues to recover and lower the incidence of incisional complications. 10 This delayed approach in calcaneal tuberosity avulsion fractures can lead to skin necrosis and severe wound complications. 10 We present a male patient who presented with avulsion fracture of the calcaneal tuberosity due to direct trauma to the calcaneal tuberosity and subsequently developed severe soft tissue complications due to delayed treatment.…”

“…10 This delayed approach in calcaneal tuberosity avulsion fractures can lead to skin necrosis and severe wound complications. 10 We present a male patient who presented with avulsion fracture of the calcaneal tuberosity due to direct trauma to the calcaneal tuberosity and subsequently developed severe soft tissue complications due to delayed treatment.…”