A suspensory fixation technique for calcaneal tuberosity avulsion fractures using the TightRope Attachable Button System

Displaced avulsion fractures of the calcaneal tuberosity generally occur as a result of osteoporotic insufficiency or high-energy injuries. Conventional methods of fixation may be complicated by wound breakdown, metalwork failure, or symptomatic hardware. This is particularly relevant in elderly patients and those with comorbidities, including osteoporosis or diabetes. We describe an innovative technique using the TightRope Attachable Button System (ABS; Arthrex, Naples, FL, USA), adapted from suspensory cortical fixation in anterior cruciate ligament reconstruction, to treat displaced Beavis type II ‘beak’ calcaneal fractures in such patients. We present the case of a 67 year old female with multiple comorbidities, who successfully underwent this procedure, with no complications at 4 years follow-up.