Calcaneus fractures with subluxation of the posterior facet - A surgical indication

The charts and radiographs of 118 patients with 126 intraarticular fracture s of the calcaneus were reviewed retrospectively. Eleven of 126 (8.7%) calc aneal fractures had injuries consisting of intraarticular calcaneal fractur e, lateral subluxation or dislocation of the posterior facet, fracture exte nsion into the calcaneocuboid joint, peroneal tendon subluxation, subluxati on of the talus in the ankle mortise, and complete disruption of the anteri or talofibular and calcaneal fibular ligaments or fracture of the lateral m alleolus, There were six women and five men. The average age was 40 years ( range, 17-65 years). The mechanism of injury was a motor vehicle accident i n eight and a fall from a height in three. According to the classification of Sanders et al eight fractures were Type II, one was Type III, and two we re Type IV. Followup at an average of 26 months (range, 14-38 months) showe d that eight of 11 patients (72.7%) had either good or excellent results. W hen lateral subluxation of the posterior facet of the calcaneus is identifi ed with a preoperative computed tomography scan, operative management is in dicated, and the surgeon should search for associated injuries that should be addressed at the time of surgery.