Calcaneal fractures that produce significant intra-articular displacement, severe disruption of the subtalar joint, or a measurable articular step-off represent a clinically distinct subset in which restoring heel anatomy and joint congruity is the central challenge.
This protocol addresses closed calcaneus fractures with significant intra-articular displacement — particularly where the subtalar joint surface is substantially involved — and fractures presenting with an intra-articular step-off. Displacement that impacts articular surfaces or produces gaps affecting joint stability and function defines this population.
Surgical intervention is the indicated pathway in this setting. The approach centres on operative reduction and fixation of the fractured calcaneus; the specific technique is determined by fracture pattern and soft tissue considerations — the full protocol specifies the options and the decision pathway between them.
Success is defined by restoration of Bohler's Angle and calcaneal height on radiograph, re-establishment of subtalar joint congruity on imaging, and resolution of heel pain.
DOI: 10.7759/cureus.54786
Fractures with significant intra-articular displacement, especially those impacting joint surfaces, may necessitate surgical intervention.
Calcaneal fractures demonstrating substantial displacement, particularly when involving the subtalar joint, often require surgical reduction and fixation.
The presence of step-offs or gaps in the articular surface, particularly those affecting joint function and stability, may necessitate surgical correction.
ORIF is a critical surgical intervention for calcaneal fractures, involving precise fracture reduction followed by internal stabilisation.
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