Calcaneus Fractures: How to Manage Them?

Abstract

Calcaneus fractures represent 1% to 2% of all fractures. They mainly affect young men (40 years old). They are divided into two subgroups: thalamic fractures, affecting the subtalar joint (75% of cases), and extrathalamic fractures, affecting the greater tuberosity, the anterior process or the internal process (25% of cases). Their diagnosis, suspected clinically, is affirmed by radiology or by computed tomography, which sometimes guides our therapeutic choices. The goal of treatment is to prevent the long-term complications of subtalar osteoarthritis and extra-articular malunion of displaced fractures, avoiding scarring and skin problems. The localization of the fracture and the importance of its displacement make it possible to make the choice between a surgical treatment or not. Orthopedic treatments are aimed at fractures with little or no displacement, or when surgery is contraindicated, bearing in mind that a calcaneal (extra-articular) malunion leads to serious sequelae, and that a malunion thalamic (articular) almost constantly leads to very poorly tolerated subtalar osteoarthritis. In the sequel stage, the only treatment for symptomatic subtalar osteoarthritis is talocalcaneal arthrodesis.