Coupon Accepted Successfully!


Management of Calcaneal Fractures

  1. Decision Making-Goals of treatment are
    1. Restoration of congruency of posterior facet of subtalar joint.
    2. Reduction of calcaneocuboid joint
    3. Reduction of width of calcaneus
    4. Restoration of height of calcaneus (Bohler angle)
    5. Decompression of subfibular space available for peroneal tendon
    6. Realignment of tuberosity into a valgus position.
  2. Type & Fracture pattern  
    1. Sanders type I (nondisplaced) fractures should be treated closed
    2. Type II & III can be treated with open reduction
    3. Type IV can be treated either closed, or in experienced hands with open reduction & immediate arthrodesis.
      Supportive splint to allow for dissipation of initial fracture hematoma, f/b conversion to plaster boot with ankle locked in neutral position to prevent equinous contracture. Early subtalar and ankle range of motion exercises initiated, and nonweight bearing restrictions are maintained for 10-12 weeks, until radiological union is confirmed.
    1. Calcaneum is the most commonly fractrued tarsal bone and in most cases the mode of injury is fall from height over 20% of these patients suffer associated injury of spine (most common), pelvis or hip and base of skull
    2. Most commonly associated injury of vertebral bodies (~12%), makes clinical & radiological examination of lumbo dorsal spine necessary in patients of calcaneum fracture.
    3. Fracture calcaneum is most often is associated with other injuries (~ 20%)
      1. Compression fracture of dorso — lumbar vertebrae (~10%)
      2. Fracture pelvis (pubic rami) and hip
      3. Fracture base of skull (atlanto —axial injury)
      4. Fracture talus
      5. Vertical compression fracture of lower end tibia
    4. Fall from height is the least important cause of fracture fibula as fibula does not lie in the direct axis of weight transmission.
    5. Transverse or short oblique fractures of fibula occur mostly due to direct blow and isolated spiral fractures are often associated with ankle injuries.
    6. Fall from height may be associated with fracture of weight transmission axis i.e. # of calcaneum, talus, lower end / shaft / upper end tibia, supracondylar / shaft /neck femur, pelvis (pubic rami), dorsolumbar spine & base of skull (atlanto axial injury).

Lisfranc fracture

Jones fracture

Test Your Skills Now!
Take a Quiz now
Reviewer Name