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Fracure Calcaneum

  1. Lateral x-rays of intraarticular fracture usually show
    1. If entire facet is separated from the sustentaculum & depressed
      1. Decrease (loss) in height of posterior facet
      2. Decrease in angle of Bohler
      3. Increase in angle of Gissane
    2. Only lateral half of posterior facet is fractured & displaced
      1. Normal Bohler & Gissane angle
      2. Split is seen as double density
  2. Radiological Feature of Fracture Calcaneum (on lateral view)
    1. Tuber angle of Bohler (Tuber-joint angle)
      1. It is formed between -A line drawn from highest points of anterior process & highest point of posterior facet and a line drawn tangentially to the superior edge of the tuberosity.
      2. It is normal between 20 - 40 degrees.
        Flattening /Reduction/Reversal of this angle indicates
        i. Weight bearing posterior facet has collapsed (intraarticular fracture) or
        ii. Degree of proximal displacement of the tuberosity (intraarticular & extra articular fracture both).
  1. Crucial angle of Gissane
    1. Formed by two cortical struts extending laterally, one along the lateral margin of posterior facet & other extending to the beak of the calcaneus Normally it is an obtuse angle of 95 - 105 degree.
    2. It increase in intra articular fracture Neutral triangle is the area between trabeculae of Calcaneum.

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