No panacea exists for fractures of the os calcis. Many methods of treatment have been proposed because of deficiency in the end-results and because of confusion over classification. Classification of these fractures is simplified by regarding the state of the subastragalar joint as the essence of the pathologic condition. I believe that open reduction, after the method of Palmer, is the treatment of choice for most fractures involving severe displacement in the posterior subastragalar joint or of it.
There are numerous methods of treating "smash" fractures of the os calcis. They vary from early mobilization2-4 to excision.13 A summary of the world literature prepared by Widén18 contains 155 references. One reason for this large number of modalities is the end-result: A treatment which works well is soon adopted. A second reason is that older classifications which have been proposed are frequently involved and are not based on
LEONARD MH. Treatment of Fractures of the Os Calcis. AMA Arch Surg. 1957;75(6):990-997. doi:10.1001/archsurg.1957.01280180122018