Internal and external fixation approaches to the surgical management of calcaneal fractures.

Calcaneal fractures are one of the most difficult fractures to surgically manage and often require a steep learning curve to achieve consistent results. They usually occur in young individuals with labor intensive occupations and are associated with major complications. Conservative treatment of intraarticular calcaneal fractures with displacement often results in significant deformity, bone loss, and posttraumatic arthrosis. Optimally, an open approach is required in most cases to achieve anatomic reduction and successful long-term outcomes.