Os Calcis Fractures

Description

Matthew Costa discusses heel fractures, differentiating between tongue types and joint depression types, and emphasizes the clinical importance of recognizing these distinctions. He notes that tongue-type fractures with displacement are surgical emergencies because the displaced fragment can tent the skin, risking breakdown. Costa shares his surgical approach, expressing concerns about effective fixation methods. He highlights recent evidence suggesting that not all heel fractures require surgery, particularly for joint depression types, based on studies indicating that anatomical reductions do not significantly improve outcomes for many patients. This has shifted his approach towards primarily non-operative treatment, with surgical intervention reserved for notable anatomical disruptions. Costa concludes with insights into evolving surgical techniques, advocating for minimally invasive approaches and acknowledging the need for more clinical trials comparing operative versus non-operative treatment for heel fractures.

DOI: 10.1302/3114-251095

Specialties