Combined Lag Screw and Cerclage Wire Fixation for Calcaneal Tuberosity Avulsion Fractures

Figure 1

(a) With the ankle in maximal plantarflexion, a periarticular reduction clamp is applied for reduction and compression of the proximal fragment. (b) The first guide wire is overdrilled with a 4.5 mm cannulated drill bit from the upper aspect of the calcaneus tuberosity to its plantar surface, advanced through the second incision at the heel, and the cerclage wire is inserted into the cannulated drill in an antegrade fashion. (c) The wire is held in place and the drill bit is removed. (d) The cerclage wire is pulled epiperiosteally to the plantar aspect of the calcaneus to avoid damage to local soft tissues, such as plantar fascia and lateral plantar nerve.

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(b)

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