Abstract
Calcaneal avulsion fracture of the Achilles tendon attachment is a relatively rare condition. We reviewed cases of this type of fracture treated with open reduction and internal fixation. Five patients with this fracture were treated in our department between July 1999 and July 2009. The patients comprised 1 woman and 4 men, who ranged in age from 31 to 91 years (mean 50.6 years). The follow-up periods ranged from 3 to 28 months (mean 11.6 months). In 4 patients the bone fragments were fixed with cancellous screws, and in 1 patient a small bone fragment was sutured to the attachment using a suture anchoring system. These 5 patients were investigated for postoperative displacement of the fragment and completion of bone union in terms of X-ray findings, residual heel pain, limitation of ankle range of motion, and skin trouble. The patient who underwent suture anchoring fixation suffered postoperative displacement of the fragment, and one patient who was treated using cancellous screws suffered partial refracture of the fragment with heel pain. However, the latter patient finally obtained reunion. Giving due consideration to fragment size and bone quality, it is necessary to develop appropriate fixation tools and postoperative protocols to reduce the incidence of the above complications.
