The instable fractures of os calcis are usually treated by conservative methods with early functional mobilization. In a few cases we think that in the Tongue Type and especially in the Joint Depression Type of Essex-Lopresti a surgical treatment may be useful to reestablish the congruence and the gometry of the joint surfaces. Some typical cases are described. Even if this active treatment of fractures of the os calcis may be generally regarded as hazardous, we think that especially in young selected individuals an operative anatomical reduction and stable fixation may be appropriate.

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