Calcaneus Fractures in the United States: Epidemiology and Surgical Trends in 89,434 Patients.

Abstract

Calcaneus fractures are the most common tarsal injuries and are associated with substantial morbidity due to their impact on hindfoot alignment and load transmission. This study evaluated nationwide incidence trends, demographic patterns, surgical management, and associated complications of calcaneus fractures from 2016 to 2024. Retrospective cohort study METHODS: Data was obtained from TriNetX U.S. Collaborative Network to identify calcaneus fractures from 2016 to 2024. Incidence and demographic distributions were calculated using age and sex-stratified cohorts. Surgical utilization was identified via CPT codes, and medical and orthopedic outcomes were analyzed. A total of 89,434 calcaneus fractures were identified, a 41% increase in incidence proportion over the study period. Fractures occurred more often in males overall, with peak incidence in younger males and postmenopausal females. Ten percent of patients underwent surgery, including open reduction internal fixation (83%), closed reduction percutaneous pinning (9%) and primary arthrodesis (8%). There was a low rate of medical and orthopedic complications (1-7%). The incidence of calcaneus fractures in the United States increased 41% over the last decade, with age-related peaks in males and females and an emerging fragility-fracture pattern in women. These findings emphasize shifting demographic trends and need for early diagnosis and treatment to improve recovery and long-term functional outcomes.