Reconstruction for Complications of Calcaneal Fractures


Calcaneal fractures constitute approximately 60% of all major tarsal injuries. Complications of calcaneal fractures can occur in either the acute or late stages of treatment. Acute complications include swelling, fracture blisters, and compartment syndrome. Late complications include posttraumatic arthrosis, malunion with loss of calcaneal height and length, widening of the calcaneus with calcaneofibular abutment, heel pad trauma, and sural neuritis. Nonsurgical management of calcaneal malunions includes the use of nonsteroidal anti-inflammatory drugs, intra-articular steroid injections, and/or prescription footwear. Surgery is indicated for patients with persistent pain and disability after conservative treatments have been exhausted. Various surgical procedures are described in this article, including medial/lateral calcaneal displacement osteotomy for varus or valgus malalignment greater than 10°, lateral wall exostectomy for peroneal tendon impingement and calcaneofibular abutment, and distraction bone block subtalar arthrodesis for significant anterior impingement secondary to loss of talar declination.

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