Ipsilateral talar and calcaneal fractures: A retrospective review of complications and sequelae

Background: Ipsilateral talar and calcaneal fractures represent a rare combination injury that has only recently been reported in the literature with small case series. Objective: To identify the commonly observed fracture patterns, complications, and outcomes of a consecutive series of patients with ipsilateral talar and calcaneal fractures. Methods: Forty-five cases of ipsilateral talus and calcanal fractures were identified from an orthopaedic trauma registry at a University-based, level I trauma center for retrospective review. Main outcome measurements: Post-operative complications, the need for secondary surgery, and the visual analogus pain score. Results: Five patients were treated with an early below knee amputation (BKA). Five patients were treated with a primary subtalar arthrodesis. Twenty-eight of the 35 patients who did not undergo early BKA or primary subtalar arthrodesis developed subtalar arthritis. Five patients had deep wound complications. Four patients had talar body collapse from avascular necrosis. There were 13 open fractures of which 8 resulted in an eventual BKA. The mean visual analogus pain score for the patient population was 4.0. Conclusion: The combination of ipsilateral talar and calcaneal fractures represents a severe injury pattern that is associated with significant morbidity. Subtalar arthritis was a common finding regardless of treatment. Open fractures frequently resulted in a below knee amputation. (C) 2008 Elsevier Ltd. All rights reserved.