Open Calcaneal Fractures: Results of Operative Treatment : Journal of Orthopaedic Trauma

Journal Logo

Original Articles

Open Calcaneal Fractures

Results of Operative Treatment

Aldridge, , Julian M. III MD; Easley, Mark MD; Nunley, James A. MD

Author Information
Journal of Orthopaedic Trauma 18(1):p 7-11, January 2004.



To review our series of open calcaneal fractures compared with other series.


Retrospective review.


All patients were treated at a single Level 1 trauma center.


We reviewed 19 consecutive patients, each with an open fracture of the calcaneus. Fracture morphology ranged from Sanders type II to type IV; associated soft tissue injuries were variable, ranging from Gustilo type I to type IIIC.


All patients were treated with intravenous antibiotics, tetanus prophylaxis, and immediate and repeat irrigation and debridement. Definitive fracture reduction was performed at an average of 7 days after injury (range 0–22 days). Fixation methods included lateral plate and screws (11), Kirschner wires and/or screws (6), or none (2).

Main Outcome Measurements 

AOFAS ankle-hindfoot scores, clinical examination, and radiographs.


All 19 patients were available for follow-up with a physical examination and radiographs at an average of 26.2 months. The AOFAS ankle-hindfoot scores averaged 81.6 (range 58–94). Five patients required free tissue transfer for wound coverage. Two patients developed chronic, draining calcaneal osteomyelitis, for which one patient underwent a below-knee amputation. In our series, for the patients with Gustilo type II and type III open calcaneal fractures, there was an 11% complication rate with higher than expected health-related quality-of-life indices.


Our findings do not reflect as high a complication rate for open calcaneal fractures as previously reported. We support previous claims that definitive hardware placement at the time of initial irrigation and debridement probably is not warranted: Definitive fracture stabilization can and should wait until soft tissue coverage is fully assessed.

© 2004 Lippincott Williams & Wilkins, Inc.

Full Text Access for Subscribers:

You can read the full text of this article if you:

Access through Ovid