In a study of 33 patients who sustained extra-articular calcaneal avulsion fractures, skin compromise at presentation was significantly associated with soft tissue complications (P = .036). The skin was threatened in 12 (36.4%) fractures and 3 (9.1%) were open at the time of presentation. Overlying soft tissue compromise was shown to have a statistically significant association with the decision for primary surgical intervention (P = .001).
Calcaneal avulsion fractures have a high incidence of soft tissue problems, failure of fixation, and need for additional surgeries. Comorbid conditions and increased age portend a poor prognosis with a significant association with wound complications and the need for additional surgeries. There was a high incidence of elderly patients and other medical comorbidities such as hypothyroidism, vascular disease, and diabetes. Many patients presented with more than 1 medical comorbidity.
Citation:
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Gardner M. Secondary soft tissue compromise in tongue-type calcaneus fractures. J Orthop Trauma. 2008;22(7):439-45.
Photo credit by Dr. Eric So, DPM