Background: Sustentaculum tali fractures are rare foot fractures accounting for 1% of all calcaneal fractures,
which accounts for about 1–2% of all bone fractures. Since the importance of sustentaculum tali in maintaining
the medial foot arch, its fractures should be dealt with anatomical fixation to avoid post-traumatic arthrosis.
Objective: Is to delineate the importance of sustentacular tali fractures fixation mentioning operative technique
and the post-operative outcome.
Methodology: Ten cases with 10 consequent closed sustentaculum tali fractures were treated by ORIF. Nine of
them were male gender. Patient’s age was 27.6 (ranged 22–40). Of those 10 cases, 7 were isolated sustentaculum
tali fractures, while 3 cases were associated by other fractures. All patients were followed-up with a follow-up
period 52.8 months (ranged 24–84 m).
Results: All fractures were united with a union rate 100%. Union appeared radiologically between 6–8 weeks
post-operatively with an average 6.8 weeks. Isolated sustentacular fractures achieved post-operative 100 score
while in the case with fractured talar neck, patient had a score 80, associated distal fibular fracture achieved 90
score, overall average score was 97 ranged 80–100. There was no recorded complication regarding to the operative
maneuver.
Conclusion: Fractures of the sustentaculum tali are rare injuries associated with high energy mechanisms. These
fractures have a high incidence of misdiagnosis. A high index of suspicion is, therefore, required when there is
pain and hematoma directly over the sustentaculum tali. Open reduction and internal fixation of these fractures
is reliable and possible through a medial approach.