Ipsilateral Fracture of the Talus with Sustentaculum Tali of the Calcaneus with a Modified Anteromedial Surgical Approach: A Case Report.

INTRODUCTION: Ipsilateral fractures of the talus and calcaneus are rare and complex injuries that pose significant treatment challenges due to the intricate anatomy of the hindfoot and potential for complications such as joint incongruity, arthritis, and avascular necrosis. CASE REPORT: A 38-year-old male presented with a rare, complex ipsilateral fracture involving the talus (extending through the neck, head, body, and posterior process with joint extension) and a comminuted sustentaculum tali fracture following a pedestrian injury. Imaging with X-ray and computed tomography scan revealed extensive fracture lines. Surgical management utilized a modified anteromedial approach for direct visualization, allowing anatomical reduction and stable fixation with screws and plates. Post-operative recovery was uneventful, and functional outcomes were good at follow-up. CONCLUSION: This case highlights the importance of meticulous pre-operative imaging and tailored surgical approaches, such as the modified anteromedial technique, in achieving optimal anatomical and functional restoration for the management of complex hindfoot fractures. Long-term follow-up is essential to monitor for complications and ensure favorable outcomes.