Abstract
Open fractures of the calcaneus are rare and difficult to treat. The frequent incidence of complications, such as skin necrosis and deep infection, creates a high risk of unsatisfactory results, as we have reported previously.
We propose the new strategic protocol for open calcaneal fractures that includes a combination of antibiotic beads and Vacuum-Assisted Closure (VAC) therapy for the wound as an initial treatment.
Only three cases have been treated using the new protocol, but none of them developed deep infection or major skin problems. Recent studies of open calcaneal fractures have reported infection rates ranging from 11% to 31%. At our hospital the infection rate for open calcaneal fractures has been 43%. Combination therapy with antibiotic beads and VAC has advantages for wound management, especially on the medial side of the calcaneus.
