PMC3758518_01
Plain lateral radiographic view without evidence of changes in shape and skeletal structure.
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F0001
At that time, plain radiographs (November 2009) did not reveal any structural bone changes (Fig. 1).
Calcaneal complete medial facet fracture without displacement associated with bone oedema (see indicators).
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F0002
One month later, due to persistent pain during the heel contact phase, a magnetic resonance imaging (MRI) was performed, which showed a complete short oblique fracture from the medial aspect of the calcaneus without displacement associated with bone oedema (Fig. 2).
Plain radiographic lateral view showing bone resorption and collapse of the anterior and medial tuberosity of the calcaneus as well as proximal displacement of the greater tuberosity.
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F0003
The studies revealed that reabsorption patterns and bone collapse in the anterior and medial tuberosity of the calcaneus as well as proximal displacement of the posterior tuberosity were evidenced due to traction of the Achilles tendon (Figs. 3 and 4).
Sagittal view of a computed tomography scan showing pseudoarthrosis and remodelling of the calcaneal tuberosity.
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F0004
The studies revealed that reabsorption patterns and bone collapse in the anterior and medial tuberosity of the calcaneus as well as proximal displacement of the posterior tuberosity were evidenced due to traction of the Achilles tendon (Figs. 3 and 4).
Plain radiographic lateral ankle view showing a subtalar joint arthrodesis with rigid internal fixation consisted of plate and screws.
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F0005
Focus consolidation was observed 3 months after the surgery (Figs. 5 and 6).
Post-operative antero-posterior ankle view showing a well-aligned ankle and hindfoot.
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F0006
Focus consolidation was observed 3 months after the surgery (Figs. 5 and 6).
PMC3758518_02
Plain radiographic lateral ankle view showing a collapse of the talar head and neck with resorption of the talus.
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F0007
Sanders and Frykberg classification), and partial reabsorption of the navicular and cuboid (Figs. 7 and 8). Stabilisation was performed by osteosynthesis using 4.5- and 6.5-mm double-threaded screws (Fig. 9).
Sagittal view of a magnetic resonance imaging showing the ankle anterior capsule breached, soft tissue oedema and bone oedema in the anterior talar body.
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F0008
Sanders and Frykberg classification), and partial reabsorption of the navicular and cuboid (Figs. 7 and 8). Stabilisation was performed by osteosynthesis using 4.5- and 6.5-mm double-threaded screws (Fig. 9).
Stabilization by osteosynthesis using 4.5- and 6.5-mm double-threaded screws.
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F0009
Sanders and Frykberg classification), and partial reabsorption of the navicular and cuboid (Figs. 7 and 8). Stabilisation was performed by osteosynthesis using 4.5- and 6.5-mm double-threaded screws (Fig. 9).
Post-operative plain radiograph showing the mechanical assembly failure and progression.
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F0010
The outcome was unfavourable due to mechanical assembly failure and reabsorption progression (Figs. 10 and 11).
Computed tomography showing absorption (tibial and calcaneal severe bone defects) after removal of osteosynthesis.
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F0011
The outcome was unfavourable due to mechanical assembly failure and reabsorption progression (Figs. 10 and 11).
Post-operative outcome of the revisional surgery included the retrograde intramedullary tibio-talo-calcaneal nailing (Panta ) for arthrodesis.
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F0012
Revisional surgery was then carried out with tibio-talo-calcaneal arthrodesis by retrograde intramedullary nailing (Panta ) (Fig. 12).