title: An alternative method of fixation of calcaneal tuberosity fractures using the Tightrope(®) technique.
abstract: Calcaneal tuberosity fractures account for 1% to 3% of all calcaneal fractures. These fractures are frequently seen in the osteoporotic or diabetic elderly population. The patient's comorbidities, coupled with the usually osteoporotic bone, make fixing this fracture pattern a challenge. Numerous surgical techniques have been advocated for this fracture, including the standard lag screw fixation, tension band wiring, suture anchors, and direct suture repair. Whichever method is used, the construct must resist the massive pull of the gastrocnemius-soleus complex. We have described a method of fixing the avulsed calcaneal tuberosity using the TightRope(®) ankle syndesmosis fixation device (Arthrex(®), Naples, FL), which offers the advantages of allowing a robust and reliable fixation of a small or comminuted fragment. It is particularly advantageous in osteoporotic bone because of concern regarding the use of standard lag screw fixation, and it also may eliminate complications associated with retained hardware.
authors.affiliation: ST4 Specialist Registrar, Department of Trauma and Orthopaedics, South-East Thames London Rotation, South London Healthcare National Health Service Trust, Sidcup, Kent, UK. Electronic address: ziadharb@doctors.net.uk.
authors.forename: Ziad
authors.initials: Z
authors.lastname: Harb
authors.forename: Sunil
authors.initials: S
authors.lastname: Dachepalli
authors.forename: Ganapathyraman
authors.initials: G
authors.lastname: Mani
mesh_terms: D000369:Aged, 80 and over; D000843:Ankle Joint / Q000601:surgery*; D002111:Calcaneus / Q000293:injuries* / Q000601:surgery*; D005260:Female; D005592:Fracture Fixation / Q000379:methods*; D050723:Fractures, Bone / Q000601:surgery*; D006801:Humans
keywords: 4; Achilles tendon; ankle; avulsion fracture; calcaneus; fixation device; surgery; syndesmosis