Calcaneal tuberosity fractures through prior Schantz pin sites in patients with diabetic neuropathy

Schantz pin placement in the calcaneal tuberosity is a common procedure known to be complicated by pin site infections and nerve injuries. Fractures through Schantz pin sites has been reported mostly in diaphyseal bone. This case series highlights three patients with type 2 diabetes mellitus and diabetic neuropathy who were fixed in an external fixator frame with a pin through the calcaneal tuberosity. At an average of 13 weeks, the patients presented with fracture through the pin site at the calcaneal tuberosity. One patient was treated with open reduction and internal fixation of the calcaneus and two patients were treated nonoperatively. These cases suggest that placement of calcaneal pins in patients with diabetic neuropathy harbors risk of iatrogenic fracture, a complication that has not been reported in the literature.