Challenge of the Week / Foot & Ankle / 10.15.2021

A 52-year-old female patient develops heel pain while doing a 20-mile charity walk. She is diagnosed with a calcaneal stress fracture. Which of the following treatments are appropriate?  
    • Open reduction and internal fixation of the calcaneus
    • This would be indicated in certain displaced acute fractures.

 

    • Immobilization in a controlled ankle motion (CAM) boot
    • Calcaneal stress fractures should be treated with immobilization in a CAM boot.

 

    • Placement of a long-leg cast
    • The use of a long-leg cast would be excessive and impose unnecessary risks (e.g., deep vein thrombosis).

 

    • Use of a bone stimulator
    • While this may be indicated for delayed or nonunions, it is not necessary for the primary treatment of a calcaneal stress fracture, especially in a healthy individual.

 

 

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