title: Treatment of Calcaneal Fracture With Severe Soft Tissue Injury and Osteomyelitis: A Case Report.
abstract: Advancements in surgical technique have resulted in the ability to reconstruct lower extremity injuries that would have previously been treated by amputation. Currently, a paucity of data is available specifically addressing limb amputation versus reconstruction for calcaneal fractures with severe soft tissue compromise. Reconstruction leaves the patient with their native limb; however, multiple surgeries, infections, chronic pain, and a poor functional outcome are very real possibilities. We present the case of a complex calcaneal fracture complicated by soft tissue injury and osteomyelitis that highlights the importance of shared decision-making between patient and surgeon when considering reconstruction versus amputation. This case exemplifies the need for open communication concerning the risks and benefits of treatment modalities while simultaneously considering the patient's expectations and desired outcomes.
authors.affiliation: Department of Orthopaedic Surgery, Case Western Reserve University School of Medicine, University Hospitals Case Medical Center, Cleveland, OH.
authors.forename: Michael
authors.initials: M
authors.lastname: Karns
authors.affiliation: Department of Orthopaedic Surgery and Sports Medicine, University of Cincinnati Medical Center, Cincinnati, OH. Electronic address: Steven.dailey@uc.edu.
authors.forename: Steven K
authors.initials: SK
authors.lastname: Dailey
authors.affiliation: Department of Orthopaedic Surgery and Sports Medicine, University of Cincinnati Medical Center, Cincinnati, OH.
authors.forename: Michael T
authors.initials: MT
authors.lastname: Archdeacon
mesh_terms: D000058:Accidental Falls; D064386:Ankle Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D002111:Calcaneus / Q000293:injuries / Q000601:surgery*; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000379:methods; D006801:Humans; D021621:Imaging, Three-Dimensional; D015601:Injury Severity Score; D057072:Intra-Articular Fractures / Q000000981:diagnostic imaging / Q000601:surgery; D023821:Limb Salvage / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000000981:diagnostic imaging / Q000601:surgery; D010019:Osteomyelitis / Q000000981:diagnostic imaging / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods*; D018570:Risk Assessment; D017695:Soft Tissue Injuries / Q000175:diagnosis / Q000601:surgery*; D013978:Tibial Fractures / Q000000981:diagnostic imaging / Q000601:surgery; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome
keywords: amputation; calcaneus; limb salvage; lower extremity reconstruction; osteomyelitis