Intra-articular neuropathic fracture of the calcaneal body treated by open reduction and subtalar arthrodesis.

Abstract

A novel pattern of neuropathic intra-articular calcaneal fracture in a diabetic patient is described. This fracture combined proximal retraction of the tuberosity and body along with hindfoot collapse and plantar ulceration. Following control of the acute Charcot process with total contact casting, surgical reduction and subtalar arthrodesis was performed to stabilize the hindfoot and decrease the risk of recurrent ulceration. After healing, the patient successfully resumed ambulation and presently uses extra-depth shoes for daily activities. Despite the risks of surgical treatment, this difficult fracture may be treated operatively to maintain plantigrade alignment and offer limb salvage for the neuropathic patient.