Calcaneus fractures: A review

Calcaneal fractures are serious injuries, and functional outcomes after these fractures are often imperfect. Calcaneal fractures can be intra- or extra-articular, with intra-articular fractures being the most common. Extra-articular fractures may involve the calcaneal tuberosity, the anterior process of the calcaneus (APC), the medial calcaneal tuberosity, or the Sustentaculum tali (ST). Conservative treatment, once considered optimal, has mostly been replaced by surgical options, except in very elderly patients, those with severe medical issues unfit for surgery, and fractures with extensive soft tissue damage. This transition to operative methods is due to a better understanding of fracture patterns from advanced imaging techniques, improved soft tissue management, the development of percutaneous and minimally invasive approaches, and the use of well-contoured locking implants. This narrative review aims to summarise innovations in imaging modalities, surgical timing and methods, fracture reduction techniques, implant technology, and postoperative care. Under the guidance of the first author, the literature was analysed using the keywords given below (PubMed, Medline, Embase, Scopus). Relevant articles were collected, and the main conclusions were combined.