Extract
To The Editor:We wish to congratulate Dr. Heier and colleagues for their contribution,
"Open Fractures of the Calcaneus: Soft-Tissue Injury Determines
Outcome"
(2003;85:2276-82). Their
article, detailing the management of open calcaneal fractures, provides
concise and much needed guidance on a daunting orthopaedic problem. This
injury has been largely ignored in the orthopaedic literature.After reviewing the article, we were surprised by the report of a deep
infection in nearly one in every five such injuries. Three recent studies have
described substantially lower rates of infection1-3. Obviously,
this difference may result from multiple variables, such as the number of
wound débridements or the adequacy of débridement, antibiotic
selection, or time to stabilization.