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The Journal of Bone and Joint Surgery (American). 2004;86:2568-2569
© 2004 The Journal of Bone and Joint Surgery, Inc.

Letter to the Editor

Open Fractures of the Calcaneus: Soft-Tissue Injury Determines Outcome

Steven J. Lawrence, MD and Gregory F. Grau, MD

Corresponding author:
Steven J. Lawrence, MD
University of Kentucky
Kentucky Clinic, K 401
740 South Limestone
Lexington, KY 40536
lzwrenc@uky.edu

The first 20% of the full text of this article appears below.

To The Editor:

We wish to congratulate Dr. Heier and colleagues for their contribution, "Open Fractures of the Calcaneus: Soft-Tissue Injury Determines Outcome" (2003;85:2276-82). Their article, detailing the management of open calcaneal fractures, provides concise and much needed guidance on a daunting orthopaedic problem. This injury has been largely ignored in the orthopaedic literature.

After reviewing the article, we were surprised by the report of a deep infection in nearly one in every five such injuries. Three recent studies have described substantially lower rates of infection1-3. Obviously, this difference may result from multiple variables, such as the number of wound débridements or the adequacy of débridement, antibiotic selection, or time to stabilization.

Heier et al. recommend a delay of definitive fixation until the wound is clean and soft-tissue swelling is minimal. . . . [Full Text of this Article]

Keith A. Heier, MD, Anthony F. Infante, DO, Arthur K. Walling, MD and Roy W. Sanders, MD

Corresponding author: Keith A. Heier, MD
Metrocrest Orthopedics
4780 North Josey Lane
Carrollton, TX 75010
kaheier@aol.com


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Related articles in JBJS:

Open Fractures of the Calcaneus: Soft-Tissue Injury Determines Outcome
Keith A. Heier, Anthony F. Infante, Arthur K. Walling, and Roy W. Sanders
JBJS 2003 85: 2276-2282. [Abstract] [Full Text]