CPT® Code 28420

Open treatment of calcaneal fracture, includes internal fixation, when performed; with primary iliac or other autogenous bone graft (includes obtaining graft)

The calcaneus, commonly known as the heel bone, is the largest of the tarsal bones in the foot and plays a crucial role in weight-bearing and movement. It articulates with the cuboid bone in the front and the talus bone above, forming essential joints that facilitate foot mobility. A fracture of the calcaneus typically occurs due to significant trauma, such as a fall from a height or a motor vehicle accident, which exerts a high-impact force on the heel. These fractures can lead to complications, including damage to the subtalar joint, which may restrict the foot's ability to perform inward (inversion) and outward (eversion) movements. The open treatment of a calcaneal fracture involves a surgical procedure where an L-shaped incision is made on the posterolateral aspect of the foot, allowing access to the fracture site. During the surgery, the subtalar joint is inspected, and the fracture is reduced using bone elevators. To maintain the reduction, temporary wire fixation is applied, and the alignment is confirmed through radiographic imaging. If necessary, internal fixation devices such as screws or plates are utilized to stabilize the fracture. In cases where an autogenous bone graft is required, a graft is harvested from the iliac crest or another donor site and is packed into the fracture area before securing the fixation device. This comprehensive approach ensures proper healing and restoration of function in the calcaneus.