Displaced avulsion fractures of the calcaneal tuberosity

Abstract

Objective: Avulsion fractures of the posterior tuberosity of the calcaneus are uncommon injuries, are produced by an abrupt contraction of the gastrocnemius-soleus complex and are associated with osteoporosis. The displaced fractures a high rate of complications, mainly related to soft tissue and surgical treatment is preferred in most of them. The purpose of this article is to analyze the different treatment options and evaluate our results. Methods: Between 2004 and 2013, 8 cases of displaced avulsion fractures of the calcaneal posterior tuberosity were treated by open eduction and internal fixation. Comorbidities, methods of fixation used and the complications were evaluated. Results: Fifty percent was observed in association with osteoporosis. 37.5% developed complications associated with soft tissue and 25% had pain by prominent tuberosity consolidation or used osteosynthesis. Consolidation was achieved in all cases. Conclusion: Open reduction and internal fixation is the treatment of choice, should be early to decrease the rate of skin necrosis and should be stable to prevent painful complications. Stability must be achieved with implants that do not require extraction procedures.