Open calcaneal fractures: results of operative treatment.

Published

Journal Article

OBJECTIVE: To review our series of open calcaneal fractures compared with other series. DESIGN: Retrospective review. SETTING: All patients were treated at a single Level 1 trauma center. PATIENTS/PARTICIPANTS: We reviewed 19 consecutive patients, each with an open fracture of the calcaneus. Fracture morphology ranged from Sanders type II to type IV; associated soft tissue injuries were variable, ranging from Gustilo type I to type IIIC. INTERVENTION: All patients were treated with intravenous antibiotics, tetanus prophylaxis, and immediate and repeat irrigation and debridement. Definitive fracture reduction was performed at an average of 7 days after injury (range 0-22 days). Fixation methods included lateral plate and screws (11), Kirschner wires and/or screws (6), or none (2). MAIN OUTCOME MEASUREMENTS: AOFAS ankle-hindfoot scores, clinical examination, and radiographs. RESULTS: All 19 patients were available for follow-up with a physical examination and radiographs at an average of 26.2 months. The AOFAS ankle-hindfoot scores averaged 81.6 (range 58-94). Five patients required free tissue transfer for wound coverage. Two patients developed chronic, draining calcaneal osteomyelitis, for which one patient underwent a below-knee amputation. In our series, for the patients with Gustilo type II and type III open calcaneal fractures, there was an 11% complication rate with higher than expected health-related quality-of-life indices. CONCLUSIONS: Our findings do not reflect as high a complication rate for open calcaneal fractures as previously reported. We support previous claims that definitive hardware placement at the time of initial irrigation and debridement probably is not warranted: Definitive fracture stabilization can and should wait until soft tissue coverage is fully assessed.

Full Text

Duke Authors

Cited Authors

  • Aldridge, JM; Easley, M; Nunley, JA

Published Date

  • January 2004

Published In

Volume / Issue

  • 18 / 1

Start / End Page

  • 7 - 11

PubMed ID

  • 14676550

Pubmed Central ID

  • 14676550

Electronic International Standard Serial Number (EISSN)

  • 1531-2291

International Standard Serial Number (ISSN)

  • 0890-5339

Digital Object Identifier (DOI)

  • 10.1097/00005131-200401000-00002

Language

  • eng