title: Landing on your own two feet: a case report of bilateral calcaneus and open pilon fractures.
abstract: High energy fractures of the distal tibial plafond and calcaneus have been associated with high functional morbidity and wound complications. Although both of these fractures result from a similar mechanism, they have rarely been reported to occur on an ipsilateral extremity. The combination of these 2 injuries on the same extremity would increase the likelihood of an adverse surgical or functional outcome. We present the case and management strategy of a 43-year-old male with bilateral open pilon fractures and closed calcaneal fractures after falling from a height. A staged protocol was used for the bilateral pilon fractures, with external fixation until operative fixation on day 9. Nonoperative management of the calcaneal fractures resulted in a successful functional outcome at 10 months of follow-up. Treatment of this fracture pattern must incorporate the condition of the soft tissues, an understanding of the fractures, and minimize patient risk factors to optimize the functional and surgical outcomes.
authors.affiliation: Resident, Department of Orthopaedic Surgery, Albert Einstein Medical Center, Philadelphia, PA. Electronic address: nathan.tiedeken@gmail.com.
authors.forename: Nathan C
authors.initials: NC
authors.lastname: Tiedeken
authors.affiliation: Resident, Department of Orthopaedic Surgery, Albert Einstein Medical Center, Philadelphia, PA.
authors.forename: David
authors.initials: D
authors.lastname: Hampton
authors.affiliation: Orthopaedic Foot and Ankle Specialist, Department of Orthopaedic Surgery, Albert Einstein Medical Center, Philadelphia, PA.
authors.forename: Gene
authors.initials: G
authors.lastname: Shaffer
mesh_terms: D000058:Accidental Falls; D000328:Adult; D016512:Ankle Injuries / Q000000981:diagnostic imaging / Q000601:surgery* / Q000628:therapy; D001860:Bone Plates; D016025:Bone Transplantation; D002111:Calcaneus / Q000000981:diagnostic imaging / Q000293:injuries*; D002985:Clinical Protocols; D016267:External Fixators; D018409:Foot Injuries / Q000000981:diagnostic imaging / Q000628:therapy; D005592:Fracture Fixation; D050723:Fractures, Bone / Q000000981:diagnostic imaging / Q000601:surgery / Q000628:therapy; D005597:Fractures, Open / Q000000981:diagnostic imaging / Q000601:surgery* / Q000628:therapy; D006801:Humans; D008297:Male; D011859:Radiography; D017695:Soft Tissue Injuries / Q000000981:diagnostic imaging / Q000601:surgery* / Q000628:therapy; D013978:Tibial Fractures / Q000000981:diagnostic imaging / Q000601:surgery* / Q000628:therapy; D014184:Transplantation, Homologous
keywords: fall from a height; heel; high energy; injury; open fracture; tibia; trauma