Displaced intra-articular calcaneal fracture with comminuted calcaneocuboid depression fracture: case report

Abstract

Background

Although it is well known that some calcaneal fractures extend to the calcaneocuboid joint, there have been no reports detailing the techniques of reduction in calcaneal fractures with severe displaced depressed calcaneocuboid joint fractures.

Purpose

We experienced a case of calcaneal fracture with severe displaced comminuted calcaneocuboid joint depression fracture. The purpose of this report is to introduce reduction and fixation techniques.

Case

51-Year-old male. He was injured after falling from a height of 6 m while pruning trees at his workplace. He was carried to his previous hospital and was urgently hospitalized with a diagnosis of left calcaneus comminuted fracture, left ankle lateral malleolar fracture, 1st lumbar compression fracture, and sacral fracture.

The patient presented with a depression type calcaneal fracture including an intraarticular depression fracture of the calcaneocuboid joint. At surgery, the depression fracture of the calcaneocuboid joint was directly molded to the cuboid, before the posterior talocalcaneal fracture was reduced and temporarily fixed to the cuboid bone with a Kirshner wire. The lateral column was opened using a spreader and shortening of the lateral column was reconstructed when the posterior talocalcaneal intra-articular fracture was reduced.

Discussion

In calcaneal fractures involving the calcaneocuboid joint, those with minor displacement are often reduced indirectly by posterior facet reduction. In cases of depression fractures of the calcaneocuboid joint with severe displacement, there is a risk of shortening of the lateral column, so length of the lateral column must be restored sufficiently. We think that dissection of the fracture site and temporary joint fixation is required for reduction.

Conclusion

For calcaneal fractures with intra-articular depression fractures of the calcaneocuboid joint, reduction techniques to reconstruct the length of the lateral column using a lamina spreader are useful, such as temporary joint fixation after reduction of the calcaneocuboid joint using Kirshner wire.