Treatment of Subacute Displaced Comminuted Intraarticular Calcaneus Fracture

Diagnostic Confirmation

• The American College of Radiology recommends obtaining CT imaging without IV contrast to fully characterize the fracture pattern, as initial radiographs have only 87% sensitivity for calcaneal fractures and frequently miss the extent of comminution and articular involvement, particularly for identifying occult osteochondral fractures of the subtalar joint 1, 2

Timing Considerations

• The American College of Radiology suggests that surgery should be performed as soon as soft tissue conditions permit in the subacute nature (defined as 3 weeks to <6 months post-injury), to allow for anatomical reduction, though it may be more technically challenging than acute intervention 1, 3

Postoperative Management

• The American College of Radiology and Praxis Medical Insights recommend maintaining non-weight-bearing status until radiographic evidence of healing (typically 8-12 weeks) and initiating physical therapy once appropriate to restore range of motion and strength 2