Management of Partial Heel Pad Avulsion using Multiple Kirschner wire Anchorage Technique - Case Report

Area of Science:

• Orthopedic Surgery
• Trauma Care

Background:

• Heel pad injuries, though rare, pose significant management challenges due to the complex anatomy and critical blood supply of the heel pad.
• The primary objective in managing heel pad injuries is to restore a functional heel pad for weight-bearing and normal gait.

Observation:

• A case report details a 46-year-old male with a partial heel pad avulsion from a motorcycle accident.
• The injury involved a contaminated wound but a viable heel pad with no associated bone damage.
• Surgical intervention involved reattaching the avulsed heel pad using multiple Kirschner wires within 6 hours of trauma, without wound closure, and with daily dressing changes.

Findings:

• The study demonstrates that multiple Kirschner wires offer a cost-effective and straightforward approach for managing partial heel pad avulsions.
• Full weight-bearing was initiated at the 12th postoperative week, indicating successful functional recovery.
• Partial-thickness avulsion injuries exhibit a more favorable prognosis compared to full-thickness injuries due to the preservation of periosteal blood supply.

Implications:

• This technique provides a viable surgical option for heel pad avulsion, potentially improving patient outcomes.
• The findings suggest that prompt surgical intervention with Kirschner wires can effectively restore heel pad function.
• Further research could explore long-term outcomes and compare this method with other surgical techniques for heel pad reconstruction.