Delayed Distraction Bone Block Arthrodesis for a Sanders IV Calcaneus Fracture Nonunion Using Tricortical Iliac Crest Allograft and Reamer/Irrigator/Aspirator Femoral Autograft.

We present the surgical technique for arthrodesis of the subtalar and calcaneocuboid joints of a Sanders type IV calcaneal fracture nonunion via a distraction bone block arthrodesis technique with tricortical iliac crest allograft combined with reamer/irrigator/aspirator autograft from the patient's femur. A lateral extensile approach to the calcaneus was used for the exposure, which allowed the surgeon to follow the stepwise complex surgical plan outlined here. Calcaneal nonunions are difficult to treat, but good outcomes can be achieved if proper technique with bone grafting is used.