Isolated Fractures of the Sustentaculum Tali: Injury Characteristics and Surgical Technique for Reduction Management

Abstract

Isolated fractures of sustentaculum tali are rare and often missed at an initial visit. They can be difficult to manage and may have implications for future hindfoot function. This article describes sustentacular fracture patterns and characteristics, and a method of surgical treatment via a medial approach to the calcaneus. During the last 6 years, 11 recent isolated sustentacular fractures without calcaneal posterior facet involvement were surgically-treated at our hospital. Of these all underwent open reduction and internal fixation via medial approach to the calcaneus. Patient charts, X-ray radiographs and CT scans were reviewed for injury characteristics and associated musculoskeletal injures. Five patients had intra-articular middle facet involvement, and two had subtalar joint subluxation. By cannulated screws reduction was maintained through fractures rigidly fixation. Isolated fracture of the sustentaculum tali is tend to be ignored and easily misdiagnosed as acute ankle sprain. Open reduction and internal fixation of this fractures was reliable and should be procedure via medial approach.