Sanders IV comminuted fractures of the calcaneus give rise, in most cases, to painful and incapacitating posttraumatic subtalar arthritis, which in many cases requires secondary subtalar arthrodesis. This arthrodesis can be technically complex, since it is not an in situ fixation, but requires the realization of correction osteotomies at the level of the calcaneus body in the same surgery. Material and methods. We present 4 patients with commensal fractures of Sanders type IV calcaneus, produced in 2017 and treated by a primary subtalar arthrodesis with concomitant reconstruction of the calcaneus body. The mean follow-up was 15 months. Results. We obtained osseous consolidation of both the arthrodesis and the fracture around 4 months, without signs of osteoarthritis in other joints. There was no complication of surgical wound, nor did other typical complications of these injuries appear, such as impingement of peroneus, problems with the footwear or blockage or degeneration of the warm talar joint during the follow-up. The AOFAS score at 12 months was 78. Conclusions. The subtalar primary arthrodesis with the initial correction of the associated deformities in the calcaneus body (shortening, widening and varus) avoids later complications and obtains good results.

Sanders IV comminuted fractures of the calcaneus give rise, in most cases, to painful and incapacitating posttraumatic subtalar arthritis, which in many cases requires secondary subtalar arthrodesis. This arthrodesis can be technically complex, since it is not an in situ fixation, but requires the realization of correction osteotomies at the level of the calcaneus body in the same surgery. Material and methods. We present 4 patients with commensal fractures of Sanders type IV calcaneus, produced in 2017 and treated by a primary subtalar arthrodesis with concomitant reconstruction of the calcaneus body. The mean follow-up was 15 months. Results. We obtained osseous consolidation of both the arthrodesis and the fracture around 4 months, without signs of osteoarthritis in other joints. There was no complication of surgical wound, nor did other typical complications of these injuries appear, such as impingement of peroneus, problems with the footwear or blockage or degeneration of the warm talar joint during the follow-up. The AOFAS score at 12 months was 78. Conclusions. The subtalar primary arthrodesis with the initial correction of the associated deformities in the calcaneus body (shortening, widening and varus) avoids later complications and obtains good results.