![]() ![]() We did a mini cortical window proximal to the calcaneal fracture to elevate the articular surface, then we reduced the cuboid bone, and we fixed the calcaneocuboid joint using two 2 mm k-wires ( Fig. We exposed the calcaneo-cuboid joint and the cuboid facet impaction. We carefully incised all the soft tissues directly to the bone and care was taken to protect the sural nerve, peroneal tendons, and the short extensor digitarum as well. ![]() A second lateral calcaneal approach extending from the base of the fifth metatarsal toward the calcaneal tuberosity. A doubt on an additional Lisfranc injury noticed intra-operatively, insertion of a 2 mm k-wire going from the first (M1) to the fourth (M4) metatarsal bases was performed ( Fig. Another 2 mm K-wire was used to fix the navicular to the C2. The joint between first and the second cuneiforms (C1C2) was disrupted and fixed by a 2 mm K-wire. After reducing these joints, we fixed the navicular bone (nav) to the first cuneiform (c1) by an LCP plate and 2.7 mm screws. Dissection was continued onto the dorsal aspects of the dislocated joint between the navicular and the cuneiforms. The tibialis anterior and extensor hallucis longus tendons were identified and protected throughout the procedure by using blunt retractors. 4) that was carried carefully through the subcutaneous tissues preserving the dorsal neurovascular bundle of the foot and superficial peroneal nerve. The first one is a dorsomedial approach ( Fig. Sagittal and axial views of CT-scan of the right foot showing the o naviculocuneiform joint dislocation (a, b) and calcaneocuboid joint fracture dislocation (c, d).Īs the skin wasn't tense and was in an acceptable level of edema, surgical treatment was decided on the same day by open reduction and internal fixation through two surgical approaches. ![]()
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