Year: 2025 | Month: August | Volume: 12 | Issue: 8 | Pages: 147-152
DOI: https://doi.org/10.52403/ijrr.20250817
Internal Fixation as Operative Management of Bilateral Calcaneal Fracture in Traveler: A Case Report
Nyoman Gilang Putrayasa*, I Wayan Subawa**, N. Indra Tri Cahyadi*
*Resident of Orthopaedic and Traumatology, Prof Ngoerah General Hospital, Faculty of Medicine, Udayana University, Denpasar, Bali, Indonesia
**Department of Orthopaedic and Traumatology, Prof Ngoerah General Hospital, Faculty of Medicine, Udayana University, Denpasar, Bali, Indonesia
Corresponding Author: Nyoman Gilang Putrayasa
ABSTRACT
Introduction: Calcaneal fractures, particularly displaced intra-articular types, pose significant treatment challenges due to complex anatomy and limited soft tissue. This report discusses ORIF for Essex-Lopresti joint depression-type fracture to restore mobility and accelerate recovery.
Case Presentation: A 37-year-old male tourist fell from a 5-meter height, presenting with bilateral heel pain and ankle bruising. Imaging confirmed bilateral intra-articular calcaneal fractures (Essex-Lopresti type). He underwent open reduction and internal fixation using calcaneal plates. Postoperative rehabilitation focused on early motion and gradual return to weight-bearing and activity.
Discussion: Intra-articular calcaneal fractures require anatomical reduction to minimize subtalar arthritis risk. This case of bilateral Essex-Lopresti joint depression-type fractures was managed with ORIF to restore alignment and function. Despite potential complications, surgical treatment enables earlier mobilization, especially in active patients. Soft tissue preservation remains critical to reduce postoperative morbidity.
Conclusions: The management of calcaneal fractures remains a delicate balance between operative and conservative approaches. When a young person has related soft tissue issues, which are frequently encountered, surgical management is likely to result in a better outcome and faster healing rates. Both operative and non-operative treatment exhibited complications.
Keywords: Intra-articular calcaneal fracture, Essex-Lopresti classification, Open reduction and internal fixation (ORIF), Joint depression type
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