Plantar Exostosis in a Malunited Calcaneal Fracture: A rare complication

Abstract

On reviewing the literature for the treatment of symptomatic, malunited calcaneal fractures, the general consensus suggests that resection of impinging bone with isolated subtalar arthrodesis for subtalar joint arthritis yields the best long term results. 10-23Moreover, some surgeons also do endoscopic calcaneal ostectomies for calcaneofibular impingement with good results. 15 We present a case of mismanaged, malunited calcaneal fracture in a young male laborer who had an unusual and rare complication of large exostosis on plantar surface of the middle portion of the calcaneus, which to our knowledge has not been reported. The patient presented with bony swelling on the sole of the foot with a painful limp and was managed operatively by excision of the exostosis with subtalar arthrodesis. The patient was symptom free after a 2 year follow-up.

The subtalar distraction bone block arthrodesis following the late complications of calcaneal fractures: A systematic review

“…This should be done in combination with any type of fusion as resection alone might provide less favorable result (27). Plantar exostosis should be resected (7). And a sliding, open-or closed-wedge osteotomy might be necessary for residual hindfoot malalignment (2)(3)(4)(42)(43).…”

“…On the other hand a severely displaced calcaneal fracture treated conservatively or a failed operative treatment where height and width are not restored will cause more than just bother from subtalar arthritis, but also from, amongst others, fibular abutment (peroneal impingement) and tibiotalar impingement. Various different techniques are available, each with modifications, to address some or all deformities and subsequent complaints after failed initial treatment of displaced intra-articular calcaneal fractures (2)(3)(4)(5)(6)(7)(8)(9)(10)(11). An overview of the most common deformities and residual complaints after a displaced calcaneal fracture and the subsequent treatment strategies is shown in Table 1.…”