Sanders IV Calcaneus Fracture Treated with Open Reduction and Internal Fixation with a Moldable Plate: A Case Report
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Abstract
Introduction: Calcaneus fractures are the most common tarsal bone fractures, affecting patients quality of life due to osteoarthrosis and a rigid gait. Management must be individualized based on fracture line characteristics, physical activity, and patient life expectancy.
Clinical case: A 70-year-old Mexican woman with a history of osteopenia fell, imaging showed traces of a multi-fragmentary fracture, including involvement of the subtalar joint and widening and displacement of the posterior tuberosity of the calcaneus. Open surgery was scheduled 72 hours later, and the patient underwent early mobilization of the ankle, knee, and hip without support.
Discussion: The calcaneus is an irregular bone that supports 50% of the forces in the foot during ambulation and standing, resulting in significant deficits after an injury. The surgical management of calcaneal fractures has been criticized for its sequelae, poor functional results, and associated risks. The best management for complex calcaneal fractures is open reduction with primary arthrodesis of the subtalar joint, resulting in a rigid, non-painful foot with adequate mobility.
Conclusion: Calcaneal fractures are challenging to manage due to their high complexity and frequency. With advances in preoperative, transoperative, and post-surgical care, traditional methods can be satisfactory. However, infrequency and complexity make it difficult to define specific management definitively.
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