Osteomyelitis of the Calcaneus With Pathologic Fracture

Pathologic fractures of the calcaneus secondary to osteomyelitis (OM) have rarely been reported in the literature. This case series describes 5 patients who were treated in our institution for chronic OM of the calcaneus and subsequently suffered a fracture of the involved calcaneus in the absence of trauma. All 5 patients had a history of insulin-dependent diabetes mellitus and were treated with a range of surgical treatments including open reduction and internal fixation, external fixation, and excision of the fracture fragment. Three (60%) of the patients required a below-the-knee amputation of the ipsilateral limb, 1 (20%) expired, and 1 (20%) experienced healing of the fracture and the associated heel wound. Pathologic fracture of the calcaneus secondary to OM is a recognized entity, although case descriptions have rarely been reported for this challenging condition.