title: Open surgical management of high energy ipsilateral fractures of the fibula and calcaneus.
abstract: BACKGROUND
  Simultaneous ipsilateral fractures of the calcaneus and fibula are the result of high-energy injuries. Open surgical treatment of both fractures can be performed with incisions based on the described blood supply of the lower extremity.
  
  
  METHODS
  A retrospective review for all patients with ipsilateral fractures of the calcaneus and fibula was performed over an eight-year period. Thirty-eight patients were identified. Eleven patients (28.9%) were treated with open reduction and internal fixation through two separate incisions. Average follow-up was 48.8 weeks.
  
  
  RESULTS
  Two patients (18.1%) required a secondary procedure. Three patients (27.2%) developed incisional cellulitis that resolved with oral antibiotics and one patient required local wound care. All fractures united.
  
  
  CONCLUSIONS
  Ipsilateral fractures of the calcaneus and fibula require open reduction and internal fixation when closed or percutaneous treatment is not appropriate. We describe an operative approach based on the angiosomes of the lower extremity that allows for treatment of these complex injuries and report the associated complications.
authors.affiliation: University of California, Irvine, Department of Orthopaedic Surgery, 101 The City Drive South, Orange, CA 92868, United States. Electronic address: jscolaro@uci.edu.
authors.forename: John A
authors.initials: JA
authors.lastname: Scolaro
authors.affiliation: University of Oklahoma - The University of Oklahoma Health Sciences Center, Department of Orthopaedic Surgery and Sports Medicine, Williams Pavilion 1380, 920 Stanton L Young Blvd., Oklahoma City, OK 73104, United States. Electronic address: Zachary-Roberts@ouhsc.edu.
authors.forename: Zachary V
authors.initials: ZV
authors.lastname: Roberts
authors.affiliation: University of Washington - Harborview Medical Center, Department of Orthopaedic Surgery and Sports Medicine, 325 Ninth Avenue, Seattle, WA 98104-2499, United States. Electronic address: beniskb@uw.edu.
authors.forename: Stephen K
authors.initials: SK
authors.lastname: Benirschke
authors.affiliation: University of Washington - Harborview Medical Center, Department of Orthopaedic Surgery and Sports Medicine, 325 Ninth Avenue, Seattle, WA 98104-2499, United States. Electronic address: barei@uw.edu.
authors.forename: David P
authors.initials: DP
authors.lastname: Barei
mesh_terms: D000328:Adult; D000369:Aged, 80 and over; D001860:Bone Plates; D002111:Calcaneus / Q000293:injuries* / Q000601:surgery; D005260:Female; D005360:Fibula / Q000293:injuries* / Q000601:surgery; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000379:methods*; D017102:Fracture Healing; D005597:Fractures, Open / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D007869:Leg Injuries / Q000175:diagnosis / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
keywords: Angiosomes; Calcaneus; Fibula; Peroneal artery