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Published on: January 24, 2018
Management of calcaneal malunion
Rahul Banerjee1, Charles Saltzman, Robert B Anderson
1Department of Orthopaedic Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA.
The Journal of the American Academy of Orthopaedic Surgeons
|January 6, 2011
Summary
Disabling malunion can occur after calcaneal (heel bone) fractures, impacting foot alignment and potentially causing arthritis. Treatment options range from conservative measures to surgery, with surgical management often yielding successful outcomes and high patient satisfaction.
Area of Science:
- Orthopedic Surgery
- Traumatology
- Podiatry
Background:
- Calcaneal fractures frequently lead to malunion, causing hindfoot deformity and pain.
- Malunion can result in loss of hindfoot height, varus alignment, and widening.
- Subsequent complications include subfibular impingement, peroneal tendon irritation, sural nerve issues, and posttraumatic arthritis.
Purpose of the Study:
- To review the diagnostic and therapeutic strategies for symptomatic calcaneal malunion.
- To evaluate the effectiveness of both nonsurgical and surgical interventions.
Main Methods:
- Systematic evaluation of symptomatic patients with calcaneal malunion.
- Review of nonsurgical treatments: activity modification, bracing, orthoses, injections.
- Review of surgical treatments: ostectomy, subtalar arthrodesis, corrective osteotomy.
Main Results:
- Nonsurgical management is effective for many patients.
- Surgical options include ostectomy, subtalar arthrodesis, and corrective osteotomy.
- Surgical management, particularly subtalar arthrodesis, reports high success rates and patient satisfaction.
Conclusions:
- Calcaneal malunion presents significant challenges, impacting foot biomechanics and function.
- A thorough evaluation is crucial for identifying pain sources in symptomatic patients.
- Both conservative and surgical approaches can be effective, with surgery offering a high likelihood of successful outcomes and patient contentment.
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