Name of the Procedure:

Open Treatment of Calcaneal Fracture with Internal Fixation and Primary Iliac or Other Autogenous Bone Graft

Summary

This surgical procedure involves realigning and stabilizing a broken heel bone (calcaneus) using internal fixation devices like screws or plates, and adding bone graft material from the patient's own body to aid healing.

Purpose

This procedure addresses fractures in the calcaneus that require surgical intervention for proper healing. The goal is to restore normal anatomy, promote bone healing, reduce pain, and improve function.

Indications

• Displaced calcaneal fractures
• Severe pain and swelling
• Instability of the foot and ankle joint
• Non-healing fractures
• Patients with good general health and bone quality suitable for grafting

Preparation

• Fasting for at least 8 hours before surgery
• Review of current medications; some may need to be paused
• Preoperative imaging studies like X-rays or CT scans
• Blood tests and a thorough medical evaluation

Procedure Description

1. Anesthesia is administered (general or regional).
2. An incision is made in the heel area to access the fractured bone.
3. The fracture is realigned and fixed in place using screws and plates.
4. Bone graft is harvested, often from the iliac crest (hip bone).
5. The grafted bone is placed at the fracture site to aid in healing.
6. The incision is closed with sutures or staples.
7. A splint or cast may be applied to immobilize the area.

Duration

The procedure typically takes 2 to 3 hours.

Setting

Performed in a hospital operating room or a specialized surgical center.

Personnel

• Orthopedic surgeon
• Surgical nurses
• Anesthesiologist
• Scrub techs and clinical support staff

Risks and Complications

• Infection
• Blood clots
• Nerve damage
• Non-union or malunion of the bone
• Pain at the graft site
• Potential for additional surgeries

Benefits

• Proper alignment and stabilization of the fracture
• Enhanced bone healing through the graft
• Reduced pain and improved function
• Potential to return to normal activities

Recovery

• Pain management with prescribed medications
• Instructions to keep the foot elevated and limit weight-bearing activities
• Follow-up appointments for X-rays and to monitor healing
• Physical therapy may be needed
• Full recovery may take several months

Alternatives

• Non-surgical management with casting or bracing
• External fixation devices
• Pros of alternatives include less invasiveness
• Cons include potentially less effective stabilization and longer healing time

Patient Experience

Patients can expect discomfort and swelling postoperatively, with pain managed through medications. Physical therapy and gradual return to activities are anticipated. Focusing on following all recovery guidelines will aid in optimal healing.