title: Open tuber calcaneus fracture caused by a meat cleaver: A case report.
abstract: BACKGROUND
  Avulsion fractures of the tuber calcanei classically occur after falling on the foot, due to the forced dorsiflexion and the sudden contraction of the Achilles tendon. Direct trauma to the back of the leg and a direct penetrating injury are also infrequent causes and may be observed predominantly in younger patients.
  
  
  METHODS
  We present a case of an open tuber calcaneus fracture resulting from a penetrating trauma in a 37-year-old patient. The fracture was reduced through the open wound and fixed using two cannulated screws. Bone union was radiologically and clinically observed at the end of the first year.
  
  
  CONCLUSIONS
  During a physical altercation, the posterior of the patient's heel was struck directly with a meat cleaver. The position of the patient during the trauma can be considered to have increased the severity and depth of the injury. In addition, even though the injury radiologically resembled an avulsion fracture and was caused by direct trauma, the fact that it was open and that the mechanism of injury differed from the norm means that it should not be evaluated as a classic avulsion fracture in the full sense. Emergency open reduction and internal fixation were applied to an open calcaneal tuberosity fracture, and the patient was started on intravenous antibiotic therapy.
  
  
  CONCLUSIONS
  Surgical techniques are successful in the treatment of open tuber calcanei fractures and an open intervention is usually required. Using cannulated screws is a good treatment option.
authors.affiliation: Department of Orthopaedics, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey.
authors.forename: Serkan
authors.initials: S
authors.lastname: Tuna
authors.affiliation: Department of Orthopaedics, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey.
authors.forename: Tahir Mutlu
authors.initials: TM
authors.lastname: Duymus
authors.affiliation: Department of Orthopaedics, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey.
authors.forename: Serhat
authors.initials: S
authors.lastname: Mutlu
authors.affiliation: Department of Orthopaedics, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey.
authors.forename: Ismail Emre
authors.initials: IE
authors.lastname: Ketenci
keywords: Cannulated screw; Meat cleaver; Open calcaneal avulsion fracture