The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons
-
Calcaneal avulsion fractures are not uncommon, and they are probably more likely in patients with osteoporosis. Closed manipulation for this type of fracture often fails to achieve acceptable reduction, and open reduction and internal fixation are usually required. However, open reduction and internal fixation with either a lag screw or Steinmann pins do not provide satisfactory fixation in patients with diabetes and elderly patients because of the presence of porotic bone. ⋯ We report the successful treatment of 3 patients with calcaneal avulsion fractures using a modified tension band wiring technique, resulting in satisfactory recovery. Re-displacement of the fragment during the initial follow-up period was not reported, and bony union was achieved in all patients. We believe this technique is a useful surgical option for the treatment of calcaneal avulsion fractures.
-
Tibial plafond fractures are technically challenging and have the potential for serious complications. Minimizing soft tissue trauma can compromise visualization of articular reduction. There has been recent interest in the use of arthroscopy to improve visualization of plafond fractures while preserving the soft tissue envelope. Here the authors offer some technical points in order to simplify a technically demanding procedure.