title: Complications associated with open calcaneus fractures.
abstract: BACKGROUND
  Literature on open calcaneus fractures is limited and inconsistent. This study's purpose was to report complications such as osteomyelitis, amputations, and soft tissue infections in open calcaneus fractures that were treated at a Level I Trauma Center.
  
  
  METHODS
  From January 1995 through December 2007, 1,157 calcaneus fractures were identified with 127 fractures being open (11.0%). Average followup time was 9.1 (range, 2 to 53) months. All open fractures were treated by a similar protocol of intravenous (i.v.) antibiotics, emergent irrigation and debridement (I&D), initial fracture stabilization if possible, subsequent I&Ds as needed, and delayed definitive fixation. One hundred fifteen open calcaneus fractures in 112 patients had sufficient followup for study inclusion. For this study complications were classified into four categories: superficial infections, deep infections, osteomyelitis, and amputations.
  
  
  RESULTS
  Medial based wounds occurred in 63 (54.8%) fractures. The overall complication rate was 23.5% with 16 fractures (13.9%) requiring a reoperation. Eleven (9.6%) fractures experienced superficial wound infection and 14 (12.2%) had deep wound infection. Six (5.2%) amputations were required with three being for either soft tissue infection or wound necrosis. Culture-positive osteomyelitis occurred in six (5.2%) patients.
  
  
  CONCLUSIONS
  Utilizing a standardized protocol, open calcaneus fractures were found to have a lower complication rate than has been previously reported.
authors.affiliation: Great Lakes Orthopedics Center, Traverse City, MI, USA.
authors.forename: Brent
authors.initials: B
authors.lastname: Wiersema
authors.forename: David
authors.initials: D
authors.lastname: Brokaw
authors.forename: Timothy
authors.initials: T
authors.lastname: Weber
authors.forename: Telly
authors.initials: T
authors.lastname: Psaradellis
authors.forename: Carlo
authors.initials: C
authors.lastname: Panero
authors.forename: Chad
authors.initials: C
authors.lastname: Weber
authors.forename: Dana
authors.initials: D
authors.lastname: Musapatika
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002111:Calcaneus / Q000293:injuries*; D002648:Child; D002985:Clinical Protocols; D003646:Debridement; D005260:Female; D050723:Fractures, Bone / Q000150:complications* / Q000628:therapy; D005597:Fractures, Open / Q000150:complications* / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D010019:Osteomyelitis / Q000453:epidemiology; D012086:Reoperation / Q000706:statistics & numerical data; D014946:Wound Infection / Q000453:epidemiology; D055815:Young Adult