Surgical Discussion

Patient positioning:  The patient was positioned supine on the operating table, with the affected limb elevated and prepared for external fixation application.

Anatomical surgical approach:  A lateral approach to the calcaneus was utilized, allowing for adequate exposure for debridement and subsequent arthrodesis. The incision extended along the lateral aspect of the foot, providing access to both the fracture site and the subtalar joint for fusion.

Direct closure of the wound was achieved despite the initial soft tissue defect. An Ilizarov external fixator was applied to maintain the foot in an equinus position, protecting the repair and allowing for gradual correction of any residual deformity as soft tissues healed.

Postoperative protocol:   Postoperatively, the patient was managed with progressive correction of deformity using the Ilizarov frame as soft tissues healed. Weight-bearing status was determined based on clinical and radiological assessment of healing progress.

Follow up:   Not specified.

Orthopaedic implants used:   Ilizarov external fixator, bone substitute material.