Calcaneus Fracture: Extended Lateral Approach

Abstract

Treating fractures of the calcaneus can prove to be challenging for the orthopedic surgeon. Historically, surgical management of these injuries has been associated with a high complication rate. Calcaneal fractures are often associated with significant soft tissue injury, local vascular disruption, and other bony injuries. Successful management of calcaneal fractures requires careful attention to patient selection, surgical timing and surgical approach in addition to appropriate imaging studies, preoperative planning, and an understanding of the anatomy. Appropriate timing of surgery and soft tissue handling techniques can minimize the incidence of wound complications and infections. The extensile lateral approach offers excellent exposure to the entire calcaneus. During surgical exposure, care should be taken not to disrupt an already tenuous vascular supply. After surgical exposure, the fracture fragments are reduced and provisionally fixed with Kirschner wires. The reduction is then confirmed fluoroscopically prior to the placement of screws and a laterally based plate.