Intra-articular Calcaneal Fracture Fixation Complicated by a Traumatic Chylous Effusion: A Case Report

Area of Science:

• Orthopedic Surgery
• Trauma Management
• Chylous Effusions

Background:

• Traumatic chylous effusions are rare complications, potentially mimicking septic arthritis.
• Calcaneus fractures, particularly Sanders type III, require precise management.
• Managing concurrent effusion and fracture presents a unique clinical challenge.

Observation:

• A 58-year-old man sustained a Sanders type III calcaneus fracture from a fall.
• Intraoperative discovery of a traumatic chylous effusion raised concerns for infection.
• Provisional K-wire reduction was performed due to suspected intra-articular infection.

Findings:

• The chylous effusion was managed concurrently with the calcaneus fracture fixation.
• Polymethylmethacrylate (PMMA) bone cement, mixed with antibiotics, was used for definitive fixation.
• This approach facilitated reduction and provided stability, avoiding traditional fixation methods.

Implications:

• Antibiotic-loaded cement can serve as an effective reduction aid in complex intra-articular fractures.
• This case highlights a successful management strategy for traumatic chylous effusion complicating calcaneus fractures.
• The findings suggest a viable alternative fixation technique in challenging orthopedic trauma scenarios.