Approach for Neglected Calcaneal Fracture-Dislocation and Associated Complications

Abstract

Calcaneal fractures lead to significant debility that can be increased due to delayed or improper surgical repair and are commonly complicated by nonunion. This report explores a unique case of neglected calcaneal fracture with malalignment complicated by subluxing peroneal tendons, arthritis of the hindfoot, and tear of the peroneal retinaculum. The operative intervention consisted of open Achilles tendon lengthening, bone block distraction arthrodesis of the subtalar joint with talonavicular and calcaneocuboid fusion, along with repair of subluxing peroneal tendons with fibular groove deepening. Postoperative imaging at 25 weeks revealed intact hardware, stable alignment, and complete osseous arthrodesis of involved joints, which was also redemonstrated at 1-year postoperative. Reports of reconstructive options for neglected calcaneal fractures that restore mobility, such as this case, are important due to the significant patient burden these injuries impose and the paucity of viably restorative options currently available. Level of Evidence: Level-IV.