An exostosis. DOI: 10.3827/FAOJ.2010.0311.0002 Corpus ID: 74737897; Plantar Exostosis in a Malunited Calcaneal Fracture: A rare complication @article{Sultan2010PlantarEI, title={Plantar Exostosis in a Malunited Calcaneal Fracture: A rare complication}, author={Asif Sultan and Tahir Ahmad Dar and Mohd Iqbal Wani and Mubashir Maqbool Wani and Samina Shafi}, journal={The foot and Ankle Online Journal}, year . the calcaneus. Intermediate to long-term results of a treatment protocol for calcaneal fracture malunions. m@2qBS"^ 1 8 ONLhrKy `:9k~ ^\X pI8T =Z U*' Aklou}l9)XOA50k |E)17"5/P +SFHKk=ln>z{hQM . This region of skin was having major contact with the ground during stance phase, and was associated with an antalgic gait style. Intensive running, wearing unsuitable shoes, overweight, aging, flat feet increase the risk of developing this spur. British volume, We carried out a retrospective review of 47 intra-articular fractures of the calcaneum treated by open reduction and internal fixation in 45 patients by a single surgeon between 1993 and 2001. JBJS 2010 92B(5): 693-700. Arch Orthop Trauma Surg 2007 127(4): 265-267. He was managed locally, only for wound care and had no proper medical or orthopedic consultation. Sanders R, Fortin PT, Walling, AK. 4. It may develop either due to articular surface depression or may occur due to secondary cartilage damage from the initial trauma. Diagnosis: Plantar exostosis of right calcaneus. What is a heel spur feel like? J Orthop Trauma 2010 24(8): 466-472. Calcaneal fractures are very common and are associated with many complications irrespective of the treatment method chosen. Though the method of sliding corrective osteotomy does not provide much improvement to the talus declination angle, it is suitable for those patients with a banana-shaped calcaneus malunion, and if the patient has prominent anterior ankle pain caused by tibiotalar impingement, a distraction subtalar arthrodesis would be more appropriate. The authors introduce a simplified technique to surgically excise a retrocalcaneal British volume, We carried out a retrospective review of 47 intra-articular fractures of the calcaneum treated by open reduction and internal fixation in 45 patients by a single surgeon between 1993 and 2001. A ligament or a tendon affected at the area where it is attached to the bone. By clicking accept or continuing to use the site, you agree to the terms outlined in our. 1. Email-drasifsultan@yahoo.com, 1Government Hospital for Bone and Joint Surgery, Barzullah. JBJS 2010 92A: 32-43. inversion and plantar flexion of the foot cause avulsion of the bifurcate ligament. Mubashir Maqbool Wani1 , Samina Shafi2, The Foot and Ankle Online Journal 3 (11): 2. He had always had difficulty in walking afterwards due to pain in the hind foot on weight bearing and abnormal prominence under the heel. Exostosis can be painless, or it can cause severe pain and require surgical removal. Chin J Traumatol 2010 13(5): 313-315. Radiographic evaluation showed malunited calcaneal fracture with reduced Bohlers angle, subtalar arthritis, minimally increased heel width and a large exostosis on the plantar surface of calcaneus. Acta Orthop Belg 2007 73(1): 60-69. What is the lump on my heel? An endoscopic lateral calcaneal ostectomy is described, in which the integrity of the soft tissue envelop is preserved and the amount of cartilage debridement needed is accurately determined. Percutaneous reduction and fixation of displaced intra-articular calcaneus fractures. Exostosis is NOT the same as a bone cyst/benign tumor. Lateral wall exostosis with peroneal tendon irritation. Increased awareness of these complications and their prevention will aid the practitioner in decision-making and result in better treatment outcomes for this fracture. Lim EVA, Leung JPF. Packaging: 1 bottle of 50ml, Insoles for calcaneal spur [1,2,6-9,17,18] Acute complications include swelling, fracture blisters, and compartment syndromes. Walter JH Jr, Rockett MS, Goss LR. These procedures require partial or complete detachment of the insertion of the Achilles tendon and ultimate resection of the exostosis. Clin Orthop Relat Res 1993 (290): 157-167. The patient was managed, The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons. Radnay CS, Clare MP, Sanders RW. JBJS 2000 82A (5): 613-624. There was a prominent bony projection on the plantar surface over the anterior aspect of heel which was tender to touch, with thick, firm, and hypertrophic overlying skin. Heel exostosis (bony calcaneal spurs) sometimes develop after injury and may also cause chronic heel pain. 18. We present a case of malunited calcaneal fracture with a rare complication of an exostosis in the middle 3 rd of the plantar surface of calcaneus which clinically produced a large bony swelling on the sole of the foot causing pain and abnormal gait .This type of plantar calcaneal exostosis to our knowledge has not been previously reported. There is clear evidence that appropriately indicated procedures are effective in terms of pain alleviation, correction of deformity, and improved function, however, longterm outcomes may improve the acceptability to jointpreserving osteotomies, subtalar arthrodesis with the VIRA implant and subt alar distraction osteogenesis. Calcaneal fractures are very common and are associated with many complications irrespective of the treatment method chosen. He had difficulty in walking for the last year. It may be associated. Foot and ankle surgery : official journal of the European Society of Foot and Ankle Surgeons, Clinical orthopaedics and related research. The. Retro Calcaneal Exostosis. 6% (132/2119) 4. %PDF-1.3 20. 2 Resident Government Medical College, Srinagar, India 190005, The Foot and Ankle Online Journal, 2010, on Plantar Exostosis in a Malunited Calcaneal Fracture: A rare complication, Gaenslen's Split Heel Approach for the Treatment of Chronic Osteomyelitis of the Calcaneus: A series of three cases, Management of an open crush fracture to the foot from a lawnmower injury: A case report, The clinical and patient centered outcomes following surgical correction of tailors bunion in an acute hospital based podiatric surgery service, Fluoroquinolone-induced Achilles tendinopathy A case report and management recommendations, Reconstruction of an Achilles rupture with 12 cm defect utilizing Achilles tendon allograft and calcaneal bone block: A case report, Congenital amniotic band constriction of the proximal tibia: A Yucatan project case report, Distal lower extremity manifestations in spina bifida patients of the Yucatan Peninsula: A 24-year retrospective case series, Management of a dislocated talar dome fracture with ankle arthrodiastasis and open reduction internal fixation: A case report, A case of recurrent hyperostotic macrodactyly. Increased awareness of these complications and their prevention will aid the practitioner in decision-making and result in better treatment outcomes for this fracture. Osteoporsis. (Fig.1A and 1B) The patient was managed operatively under spinal anesthesia. Huang PJ, Fu YC, Cheng YM, Lin SY. We present a case of mismanaged, malunited calcaneal fracture in a young male laborer who had an unusual and rare complication of large exostosis on plantar surface of the middle portion of the calcaneus, which to our knowledge has not been reported. The plantar fascia is a fibrous tissue similar to a tendon that links the heel to the forefoot. This was not the cause of pain in our patient as his heel pad was more firm, harder, thickened, and less mobile than the normal side. Pathology Dr. Heath performs the procedures in an outpatient setting at a state of the art facility. View 2 excerpts, references results and background, Knee Surgery, Sports Traumatology, Arthroscopy. Semantic Scholar is a free, AI-powered research tool for scientific literature, based at the Allen Institute for AI. Complications of intraarticular calcaneal fractures. Romash MM. Some of these cookies are essential to the operation of the site, while others help to improve your experience by providing insights into how the site is being used. The authors describe an apophyseal injury of the calcaneus in a child that resulted in a compound deformity consisting of three separate exostoses. red or warm skin on back of heel. 21. A 19 year-old male, manual laborer, living in tribal hilly area presented to us with pain in left rearfoot with prominent swelling on the plantar surface and anterior part of the heel. . A technique to resect the offending posterior calcaneal bone spike to relieve the posterior ankle impingement pain is described. JAPMA 2004 94(4): 382-388. The 2023 edition of ICD-10-CM M89.8X7 became effective on October 1, 2022. Other symptoms associated with these potential . This injury healed in 4 weeks, but he still was unable to walk for another two months. Reddy V, Fukuda T, Ptaszek AJ. A technique to resect the offending posterior calcaneal bone spike to relieve the posterior ankle impingement pain is described. However, there are currently a number of discrepancies in the literature regarding the anatomical relations, histological descriptions and clinical associations of PCS. 12. spur, and/or Achilles tendinitis. 3% (63/2119) 5. It covers the indication, surgical approach, postoperative care, and presents the results reported at least one yea 8. Clin Podiatr Med Surg 2009 26(1):79-90. Subtalar arthrodesis was performed after denuding cartilage from both the articular surfaces of the calcaneus and talus. 23. Subtalar arthrodesis following calcaneal fracture. There is clear evidence that appropriately indicated procedures are effective in terms of pain alleviation, correction of deformity, and improved function, however, longterm outcomes may improve the acceptability to jointpreserving osteotomies, subtalar arthrodesis with the VIRA implant and subt alar distraction osteogenesis. It is a calcification, spur shaped, located at the plantar fascia level under the heel bone (the calcaneus). stream This calcaneal spur can be revealed most of the time by X-ray. These deformities were corrected by resection of, Archives of Orthopaedic and Trauma Surgery. Excessive and repeated tractions can cause micro lesions on the posterior insertion of the plantar fascia and cause an inflammatory reaction, then a beginning of ossification. Symptoms of heel spurs can include: sharp pain like a knife in the heel when standing up in the morning. Today's podiatrist has the necessary education and training to treat all conditions of the foot and ankle and plays a key role in a keeping America healthy and mobile while helping combat diabetes and other chronic diseases. There is no conflict of interest related to this article. American volume. Relief of pain or deformity by removal of prominence of bone (exostosis). Subtalar joint arthritis causes pain on weight bearing, aggravated by varus or valgus stressing of the subtalar joint without significant tenderness to the lateral aspect of heel with or without radiological evidence. (Fig.3) The patient had returned to his pre-injury employment as manual laborer and the result was deemed good. This includes: psoriatic arthritis. H=44W$a|h ~Y"a`lE Cs'p [r&U e"kGKU"~VQ8(ZcT__^Isg_WW}'>~G/~W~{/VB}~V_? View 2 excerpts, references results and background, Knee Surgery, Sports Traumatology, Arthroscopy. Calcaneal fractures are very common and are associated with many complications irrespective of the treatment method chosen. [6-9], On reviewing the literature for the treatment of symptomatic, malunited calcaneal fractures, the general consensus suggests that resection of impinging bone with isolated subtalar arthrodesis for subtalar joint arthritis yields the best long term results. We present a case of malunited calcaneal fracture with a rare complication of an exostosis in the middle 3rd of the plantar surface of calcaneus which clinically produced a large bony swelling on the sole of the foot causing pain and abnormal gait .This type of plantar calcaneal exostosis to our knowledge has not been previously reported. The diagnosis is an enthesitis with spur. 16. [1] Even though recent studies have shown better results with surgical treatment [2-5] and less invasive stabilization systems [3-5], the treatment of calcaneal fractures remains controversial because of the suboptimal results of treatment and the incidence of complications associated with both conservative and surgical methods. bone located at the posterior-superior aspect of. @mOV_zM@0_&cR^(m2|s}m#.`s&D .ol.VIhBnRQjJM|6~k~=RimooVJ"%lF/A%Oj{Q]hC'Z*> }R5j.cd 12? Clare MP, Lee WE 3rd, Sanders RW. Achilles Heel Spur (retrocalcaneal exostosis) Achilles bone spurs occur at the back of the heel, where the Achilles tendon attaches the bone. % An endoscopic lateral calcaneal ostectomy is described, in which the integrity of the soft tissue envelop is preserved and the amount of cartilage debridement needed is accurately determined. Makki D, Alnajjar HM, Walkay S, Ramkumar U, Watson AJ, Allen PW. This bony prominence causes difficulty in wearing shoes, tenderness and pain. Lui TH. - Wearing EPITAL insoles (with arch support to take the stress off the plantar fascia, and of course avoiding the painful area to relieve the pain) anti calcaneal spur; - Focus on wearing shoes with heels of about 2 cm. DeWall M, Henderson CE, McKinley TO, Phelps T, Dolan L, Marsh JL. swelling around the back of your heel area. The goal of retrocalcaneal exostosis surgery is to remove the extra bone, remove any scar tissue and damaged tendon, repair tendon tissue, alleviate pain, allow a return to normal shoes, and help to allow a return to desired activities. [15]. We present a case of malunited calcaneal fracture with a rare complication of an exostosis in the middle 3rd of the plantar surface of calcaneus which clinically produced a large bony swelling on the sole of the foot causin. 2. stiffness. Epidemiology Plantar calcaneal spurs tend to usually occur in older men and women and may be related to obesity, osteoarthritis and current or previous heel pain. It can occur in many parts of the body. [2]. Enthesopathy can also be a symptom of an underlying condition. Range of motion at the subtalar joint was restricted and painful with increased heel width and no varus or valgus deformity of heel. [1] Most of these fractures occur in male industrial workers and lead to significant economic impact because of long-term disability. In this article, the current thinking regarding the treatment of these very difficult fractures will be reviewed. Easley ME, Trnka HJ, Schon LC, Myerson MS. Isolated subtalar arthrodesis. A lateral approach with sharp dissection to raise a full thickness flap from skin to periosteum was performed. The Journal of bone and joint surgery. These deformities were corrected by resection of, Archives of Orthopaedic and Trauma Surgery. 22. Figure 3 Lateral radiograph at 2 years follow-up showing subtalar fusion with staples in-situ. The plantar calcaneal spur (PCS) is a bony outgrowth from the calcaneal tuberosity and has been studied using various methods including cadavers, radiography, histology and surgery. 0O nCc}5Vj&tK In our patient, operative intervention was performed using a lateral approach as both inferior wall exostectomy (resection of exostosis)[10] and isolated subtalar arthrodesis [11-13] were performed using a single incision. If, despite wearing the insoles, the pain is still present after several weeks, go see your doctor. Subtalar fusion after displaced intra-articular calcaneal fractures: Does initial operative treatment matter? ICD-10-CM Code for Calcaneal spur, right foot M77.31 ICD-10 code M77.31 for Calcaneal spur, right foot is a medical classification as listed by WHO under the range - Soft tissue disorders . 5. An exostosis is an extra growth of bone that extends outward from an existing bone. J Trauma 1998 45(4):729-737. JBJS 2004 86B(5): 659-668. Srinagar, India 190005. Quick response from 10 a.m. to 12 p.m. and from 2 p.m. to 6 p.m. Monday to Friday, Telephone interview with an Orthopedist-Orthotist, Massage cream for heels with essential oil wintergreen scented Bio On clinical examination the patients left foot had an irregular scar of 4 cm over the anterolateral aspect of the foot. Plantar calcaneal spurs , or sometimes simply referred to as calcaneal spurs, are a commonly seen finding in radiology practice. by Asif Sultan1 ,Tahir Ahmad Dar1 ,Mohd Iqbal Wani1 , Subtalar arthritis. 3. JBJS 2000 82A: 225-250. Various procedures have been described for removing a retrocalcaneal exostosis. Chen YJ, Huang TJ, Hsu KY, Hsu RW, Chen CW. Rammelt S, Grass R, Zawadski T, Biewener A, Zwipp H. Foot function after subtalar distraction bone-block arthrodesis. The plantar fascia is a fibrous tissue similar to a tendon that links the heel to the forefoot. Calcaneus fractures are the most common fractured tarsal bone and are associated with a high degree of morbidity and disability. Written informed consent was obtained from the patients guardian for publication of this case report and accompanying images. American volume. He had sustained a crushed wound over the left foot which was accompanied by severe pain and the inability to walk. M77.32 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. Complications of intra-articular fractures of the calcaneus. [10-23] Moreover, some surgeons also do endoscopic calcaneal ostectomies for calcaneofibular impingement with good results. In this case there is an enlargement of the posterior calcaneum, which results in a fraying of the achilles tendon on the calcaneum. Its role is to underpin the arch of the foot in order to work as a cushion. I read somewhere years ago the same thing you mentioned - 'bossing' should point you to 'removal of bone or excess bone' as in 'part of the bone' as in 28122. A copy of the written consent is available for review by the Editor-in-Chief of this journal. Osteosynthesis of displaced intra-articular fractures of the calcaneum: a long-term review of 47 cases. 10. Barzullah, Srinagar, India 190005. [2] Heel pad pain is the second most common site of pain after pain over lateral aspect of heel after a calcaneal fracture [2] and have thinning with increased mobility of the pad, and a softer, less firm heel pad compared to the normal side. Abend L, Berstein DA, Wagreich C. Post-traumatic heel deformity. Associated injuries. Endoscopic lateral calcaneal ostectomy for calcaneofibular impingement. Address correspondence to: Asif Sultan , Government Hospital for Bone and Joint Surgery. Calcaneus malunion and nonunion. Posterior ankle impingement syndrome caused by malunion of joint depressed type calcaneal fracture. J Foot Surg 1986 25(2): 146-148. We present a case of malunited calcaneal fracture with a rare complication of an exostosis in the middle 3rd of the plantar surface of calcaneus which clinically produced a large bony swelling on the sole of the foot causing pain and abnormal gait .This type of plantar calcaneal exostosis to our knowledge has not been previously reported. Robinson JF, Murphy GA. Arthrodesis as salvage for calcaneal malunions. Common types of exostoses include bone spurs, which are bony growths also known as osteophytes. 7. These develop from the undersurface of the calcaneus in patients with injuries to the plantar cortex. Retrocalcaneal exostosis refers to the formation of a bony prominence at the back of the heel bone called the calcaneus. This painful condition is often related to the chronic tugging of a tight Achilles tendon on the heel bone. Request PDF | On Nov 1, 2010, Asif Sultan and others published Plantar Exostosis in a Malunited Calcaneal Fracture: A rare complication | Find, read and cite all the research you need on ResearchGate 17. In our patient, the plantar exostosis was on the plantar surface of calcaneus in the middle third of the calcaneus, well anterior to the origin of plantar fascia, thus being a rare inferior surface exostosis rather than heel exostosis. (retrocalcaneal bursitis), posterior calcaneal. Though the method of sliding corrective osteotomy does not provide much improvement to the talus declination angle, it is suitable for those patients with a banana-shaped calcaneus malunion, and if the patient has prominent anterior ankle pain caused by tibiotalar impingement, a distraction subtalar arthrodesis would be more appropriate. Lui TH. The patient presented with bony swelling on the sole of the foot with a painful limp and was managed operatively by excision of the exostosis with subtalar arthrodesis. The. This site uses cookies. Accepted: October, 2010 Sanders R. Current concepts review: Displaced intraarticular fractures of the calcaneus. These are as a consequence of proliferative bony changes at the origin of planter fascia. 15. This is the American ICD-10-CM version of M89.8X7 - other international versions of ICD-10 M89.8X7 may differ. (Fig.1) Our result was good with pain free arthrodesis of the subtalar joint. Post-traumatic arthritis after intra-articular calcaneal fractures may affect the subtalar or calcaneocuboid joint. Late complications include arthritis, malunion, lateral exostosis, calcaneofibular abutment, tendon impingement, heel pad problems and reflex sympathetic dystrophy. This article looks at how enthesopathy is caused, as well as . 5 0 obj Foot Ankle Surg 2009 15(4): 207-209. Adapted to sport, city and dress shoes, Orthopedic insoles in accordance with the specifications, Realization of personalized plantar orthoses, Payment by credit card / check / bank transfer, CALCANEAL Spur or Lenoir spur or calcaneal exostosis, 10 a.m. to 12 p.m. and from 2 p.m. to 6 p.m. Monday to Friday, Hyper pressure under the 5th metatarsal head. There were no post operative complications. We hypothesize that severe crushing force anteriorly and laterally caused collapse of the calcaneal body to the middle, also fracturing the inferior cortex and taking a large bony fragment plantarly which developed into large bony exostosis. Hernanz Gonzlez Y, Daz Martn A, Jara Snchez F, Resines Erasun C. Early results with the new internal fixator systems LCP and LISS: a prospective study. BUT - look at the CPT section for leg and ankle joints. ?w?kG7;A?o~p?yt_K~_?/[_O?s}~FdU_e3f[y@aD{b/$,= ]1.Y}=_R8Xp=|IT~Fod In this article, the current thinking regarding the treatment of these very difficult fractures will be reviewed. If this is from under the toe nail it may be referred to as a subungual exostectomy. The 2023 edition of ICD-10-CM M77.32 became effective on October 1, 2022. 11. 6. Myerson MS, Quill GE Jr. Late complications of fractures of the calcaneus. x}eu{o;}"[yFD`yr;HO d H,)V}9FUVVJlZ Wop"vE^|DR~+NP\o|5? Posterior Calcaneal Spur/ Insertions Tendinopathy / Bursitis - General points A special form of chronic achilles tendon pain is the posterior calcaneal spur, often referred to as Haglund exostosis. Its role is to underpin the arch of the foot in order to work as a cushion. DOI: 10.3827/FAOJ.2010.0311.0002 Corpus ID: 74737897; Plantar Exostosis in a Malunited Calcaneal Fracture: A rare complication @article{Sultan2010PlantarEI, title={Plantar Exostosis in a Malunited Calcaneal Fracture: A rare complication}, author={Asif Sultan and Tahir Ahmad Dar and Mohd Iqbal Wani and Mubashir Maqbool Wani and Samina Shafi}, journal={The foot and Ankle Online Journal}, year . <> This is the American ICD-10-CM version of M77.32 - other international versions of ICD-10 M77.32 may differ. A prospective study. A Haglund's deformity is a prominence of. 9. Minimally invasive plate internal fixation for calcaneal fractures. There was no cartilaginous cap on the exostosis. Subtalar distractional realignment arthrodesis with wedge bone grafting and lateral decompression for calcaneal malunion. Foot and ankle surgery : official journal of the European Society of Foot and Ankle Surgeons, Clinical orthopaedics and related research. The exostosis was used as graft material and fixed with two staples and a short leg cast was applied after closure. When the exostosis is covered with cartilage, it's called an osteochondroma. It can feel like widespread joint pain. By clicking accept or continuing to use the site, you agree to the terms outlined in our, Plantar Exostosis in a Malunited Calcaneal Fracture: A rare complication. Semantic Scholar is a free, AI-powered research tool for scientific literature, based at the Allen Institute for AI. JBJS 2005 87A (5): 963-973. Enthesopathy is a health concern relating to the connection of joints and ligaments to a bone. joint space narrowing. After three months of sustained injury, the patient began to walk with a limp and also had noticed hard swelling under the heel. The Journal of bone and joint surgery. loss of movement . Current reasoning is that abnormal biomechanics (excessive or abnormal pronation) is the prime etiological factor for a painful plantar heel and inferior calcaneal spur. Packaging: 1 pair 4rL@\s $ v!2 -R|sG((c\h$}CPFt;U@ Q*2^3}.kQ:d k-5u`0lCI7W[ At 2 years follow-up the patient was pain free with no limp and had a good subtalar fusion. Reconstructive osteotomy of the calcaneus with subtalar arthrodesis for malunited calcaneal fractures. Published: November, 2010, ISSN 1941-6806 Lateral exostosis usually develops after malunion of calcaneal fractures and is a very common complication. The spur is thought to be a result of the biomechanical fault and an incidental finding when associated with a painful plantar heel. Foot Ankle Clin 2007 12(1): 125-135. However, there are currently a number of discrepancies in the literature regarding the anatomical relations, histological descriptions and clinical associations of PCS. (Fig. 2) Sutures were removed after 3 weeks and a short leg cast was reapplied for 3 months with non-weight bearing for 6 weeks and partial weight bearing for another 6 weeks. Subtalar arthrodesis for late sequelae of calcaneal fractures: fusion in situ versus fusion with sliding corrective osteotomy. Exostosis, also called osteoma, is a benign growth of new bone on top of existing bone. Clin Ortho Related Research 2001 391:7-16. The authors describe an apophyseal injury of the calcaneus in a child that resulted in a compound deformity consisting of three separate exostoses. Subscribe to Codify by AAPC and get the code details in a flash. This was indicated for painful subtalar arthritis with normal heel height and normal tibiotalar alignment. The Journal of bone and joint surgery. The patient was managed, The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons. The patient was managed operatively by exostectomy with subtalar arthrodesis and had a good result at 2 years follow-up. He had suffered a crushing injury to his left foot while at work in his native place when a heavy stone fell on his left foot from the antero-lateral aspect. pain in calf muscles when running or walking. 19. This could be at the tip or side or through the top of the toe if the nail is removed.This procedure requires stitches. Foot Ankle Clin 2002 7(1): 107-120. Calcaneal fractures are very common and are associated with many complications irrespective of the treatment method chosen. [23] This procedure of isolated subtalar arthrodesis has been well documented with good results, [11-14, 23] and is consistent with our case. Complications associated with operative treatment include wound dehiscence, infection, arthritis, stiffness, and iatrogenic nerve and tendon injury. PURPOSE OF THE STUDY The plantar calcaneal spur (inferior calcar calcanei) is a frequent source of foot pain. The patient was symptom free after a 2 year follow-up. Foot Ankle Int 1999 20(3): 166-170. The Procedure An incision is made by the bony prominence. When the exostosis is covered with cartilage, it's called an. A case of malunited calcaneal fracture with a rare complication of an exostosis in the middle 3 rd of the plantar surface of calcaneus which clinically produced a large bony swelling on the sole of the foot causing pain and abnormal gait is presented. The proper CPT code for correcting a. Haglund's deformity depends on what specifically. The spur is often hook-shaped and grows in the direction of the plantar fascia. Orthop Trans 1991 15: 656. Calcaneal spurs can be located at the back of the heel (dorsal heel spur) or under the sole (plantar heel spur). M89.8X7 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. 14. X-ray revealing the presence of calcaneal spur. JBJS 1993 75A: 331-341. Pathologies > CALCANEAL Spur or Lenoir spur or calcaneal exostosis It is a calcification, spur shaped, located at the plantar fascia level under the heel bone (the calcaneus). Key words: Calcaneus, fracture, complications, plantar exostosis, exostectomy, subtalar arthrodesis. pain when leaning back on your heels. 30 related questions found. We present a case of malunited calcaneal fracture with a rare complication of an exostosis in the middle 3 rd of the plantar surface of calcaneus which clinically produced a large bony swelling on the sole of the foot causing pain and abnormal gait .This type of plantar calcaneal exostosis to our knowledge has not been previously reported. The pain is sharp, located under the heel which makes walking difficult. The plantar calcaneal spur (PCS) is a bony outgrowth from the calcaneal tuberosity and has been studied using various methods including cadavers, radiography, histology and surgery. Knee Surg Sports Traumatol Arthrosc 2008 16(7): 687-689. Figure 2 Immediate post operative lateral radiograph after removal of exostosis and subtalar arthrodesis. [+tgD}oz~O`sNzRXPaHSAC*)>^bd9;3ZQxvPB!JY'tBhzi(X(;: M~NKY}M#]yZe`,_m 6Hg3hT'l-cEZjHSb&:\XH%kpmR`cw4j]KJA%PGV+L@Cr Calcaneal fractures are very common and are associated with many complications irrespective of the treatment method chosen. Exostosis, also called osteoma, is a benign growth of new bone on top of existing bone. 13. Figure 1A and 1B Lateral (A) and axial (B) view radiographs showing large plantar exostosis, loss of Bohlers angle and subtalar arthritis with normal tibiotalar alignment. Request a Demo 14 Day Free Trial Buy Now. E&*jPB SX8=WLcj\= !&`::Drbwp>slmA%||% Complications of calcaneal fractures occur in the acute and late stages and after operative or non-operative treatment. Complications from non-operative treatment include arthritis, pain, malunion, and stiffness. The Journal of bone and joint surgery. Xp1I xcu9g. with "prominence of a bursal projection". Shan SL, Xu JL, Yao SZ, Yu GS, Liu YQ. DOI: 10.3827/FAOJ.2010.0311.0002 Corpus ID: 74737897; Plantar Exostosis in a Malunited Calcaneal Fracture: A rare complication @article{Sultan2010PlantarEI, title={Plantar Exostosis in a Malunited Calcaneal Fracture: A rare complication}, author={Asif Sultan and Tahir Ahmad Dar and Mohd Iqbal Wani and Mubashir Maqbool Wani and Samina Shafi}, journal={The foot and Ankle Online Journal}, year . Figure 2 Immediate post operative lateral radiograph after removal of exostosis and subtalar arthrodesis. It can occur in many parts of the body. A. Sultan, T. A. Dar, Mohd Iqbal Wani, M. M. Wani, Samina Shafi. A large plantar exostosis was excised along with associated surrounding bursa. Manasseh N, Cherian VM, Abel L. Malunited calcaneal fracture fragments causing tarsal tunnel syndrome: a rare cause. The study presents the results of calcaneal spur excision by open surgery. doi: 10.3827/faoj.2010.0311.0002, The calcaneus is the most frequently fractured tarsal bone, with calcaneal fractures accounting for 65% of all tarsal injuries and approximately 2% of all fractures. Stapleton JJ, Belczyk R, Zgonis T. Surgical treatment of calcaneal fracture malunions and posttraumatic deformities. spondyloarthritis. This pain has been attributed to crushing of the heel pad during injury. 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