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Published on: November 8, 2024
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Open Calcaneus Fractures and Associated Injuries
Jacob R Worsham1, Mark R Elliott1, Anthony M Harris2
1Orthopaedic Surgery Resident, Department of Orthopaedic Surgery and Rehabilitation, University of Florida College of Medicine-Jacksonville, Jacksonville, FL.
Summary
Open calcaneus fractures are severe, high-energy injuries often linked to other orthopedic and systemic traumas. Early management, including antibiotics and debridement, is crucial to prevent complications like amputation.
Area of Science:
- Orthopedic Surgery
- Trauma Care
- Radiology
Background:
- Open calcaneus fractures result from high-energy trauma.
- These injuries frequently involve associated orthopedic and systemic damage.
- Prompt recognition and management are vital for patient outcomes.
Purpose of the Study:
- To analyze the incidence and patterns of associated injuries in open calcaneus fractures.
- To identify risk factors for poor outcomes, including amputation.
- To review initial management strategies for these severe injuries.
Main Methods:
- Retrospective review of 62 patients with open calcaneus fractures (2003-2013).
- Data collected included demographics, injury mechanisms, wound characteristics, associated injuries, and treatment.
- Statistical analysis of injury patterns and treatment outcomes.
Main Results:
- Motor vehicle accidents (56.4%) and falls >6 ft (24.1%) were common mechanisms.
- High rates of associated injuries were observed: femoral shaft fractures (12.9%), ipsilateral ankle fractures (22.5%), spinal fractures (14.5%), and pulmonary injuries (20.9%).
- Five patients (8.0%) required below-the-knee amputation, with Type III open injuries showing increased risk.
Conclusions:
- Open calcaneus fractures are severe injuries with significant associated orthopedic and systemic morbidity.
- Vigilance for concomitant injuries and appropriate management, including antibiotics and urgent debridement, are essential.
- Type III open fractures necessitate aggressive management to mitigate amputation risk.
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