Avulsion fracture of the calcaneus treated with a knotless suture bridge and cannulated cancellous screw: a case report.

Calcaneal tuberosity avulsion fractures are rare injuries predominantly occurring in elderly women with osteoporosis. Although lag screw fixation has been widely employed, fixation failure remains a significant concern in osteoporotic bone, and no consensus on the optimal fixation method has been established. A 69-year-old woman sustained a right heel injury. Radiographs and computed tomography revealed a Beavis type I calcaneal tuberosity avulsion fracture. Osteosynthesis was performed using cannulated cancellous screw fixation combined with a knotless suture bridge (SpeedBridge). Weight-bearing was initiated at three weeks with an Achilles tendon boot, and the brace was removed at seven weeks. In Beavis type I fractures, reliable fixation with screws alone is difficult. The knotless suture bridge provides vertical compression force for fragment stabilization while eliminating knot prominence, potentially reducing soft-tissue complications. This dual fixation technique may represent a useful option for these fractures in osteoporotic patients.