Calcaneal Fracture Solutions Case Study

PATIENT HISTORY: 54-year-old man presents to the orthopaedic office several days after falling off a ladder from a height of approximately four and a half feet. He was immediately seen in the emergency room where he was splinted and told to ice and elevate the foot and ankle. X-rays of his lumbar spine revealed no injury to the vertebrae. Upon his initial visit to the office he was found to have significant swelling and discoloration to the hindfoot. He had appropriate pain and was neurovascularly intact in the foot. His X-rays revealed a comminuted but essentially nondisplaced calcaneus fracture. A CT scan revealed a comminuted calcaneus fracture with minimal subtalar displacement, but with an obvious small subtalar loose fracture fragment. Given the swelling and ecchymosis, we determined that the patient would return in 7 to 10 days for reevaluation. His past medical history is fairly insignificant except for smoking about one pack of cigarettes per day. He was advised that this may impede healing as smoking can lead to nonunion after a fracture. He underwent the appropriate preoperative clearance and we determined to perform the operation on day 17, post-injury. He was otherwise compliant with initial fracture management and returned for follow-up examination a week later.