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Treatment for a fracture is based on the type of break, the bone affected, and the patient's age.
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the...
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Osteomyelitis of the Calcaneus With Pathologic Fracture.

Maryellen P Brucato1, Matthew F Wachtler1, Ellianne M Nasser2

  • 1Attending Physician, Atlantic Health System, Morristown, NJ.

The Journal of Foot and Ankle Surgery : Official Publication of the American College of Foot and Ankle Surgeons
|January 28, 2019
PubMed
Summary

Pathologic fractures of the calcaneus due to osteomyelitis (OM) are rare. This case series highlights the severe outcomes in diabetic patients with OM, including high rates of amputation and mortality.

Keywords:
amputationcalcaneusdeathdiabetes mellituspathologic fractureprobe to boneulcer

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Area of Science:

  • Orthopedics
  • Infectious Diseases
  • Podiatry

Background:

  • Pathologic fractures of the calcaneus secondary to osteomyelitis (OM) are infrequently documented.
  • Chronic OM of the calcaneus presents a significant clinical challenge, particularly in patients with diabetes mellitus.

Purpose of the Study:

  • To describe the clinical course and outcomes of patients with chronic calcaneal osteomyelitis who experienced pathologic fractures.
  • To highlight the challenges in managing this rare complication.

Main Methods:

  • A case series of 5 patients with chronic calcaneal osteomyelitis and subsequent non-traumatic calcaneal fractures was retrospectively reviewed.
  • Patients were treated with various surgical interventions, including open reduction internal fixation, external fixation, and fragment excision.

Main Results:

  • All 5 patients had a history of insulin-dependent diabetes mellitus.
  • Sixty percent (3/5) of patients required below-the-knee amputation.
  • One patient expired, and one patient achieved fracture and wound healing.

Conclusions:

  • Pathologic fracture of the calcaneus secondary to OM is a serious complication, especially in diabetic patients.
  • Management is challenging, with a high incidence of severe outcomes including amputation and mortality.
  • This condition, though rare, requires careful consideration in the treatment of chronic calcaneal osteomyelitis.