Fractures of the talus and the calcaneus

Talus fractures are rare injuries (3 parts per thousand). The peculiar position of the bone in the foot arch and its sophisticated connection to the different joints complicate the treatment of the fracture. The blood supply poses a particular problem. Grade IV fractures according to Hawkins or Marti and Weber in the relevant literature show a rate of necrosis of 30-100%. Since the individual surgeon very rarely faces the stabilisation of a talus fracture, these procedures should be carried out in a qualified centre; the measures of emergency service, however, must be feasible everywhere. Calcaneus fractures are considerably more common, especially among among construction workers. Due to its complex anatomy and the relatively high incidence of wound healing disorders, the calcaneus also demands high standards of the surgeon. The intraoperative control of the reposition success is still a problem. Despite broad application of a standardised surgical technique, considerable deficiencies with impairment of earning capacity remain for most accident casualties.