What do you observe in this fracture?
Which view 2?
Which ligament 3?
What are the possible mechanism of injury 4?
What are the predisposing conditions 5?
1. Avulsion fracture
2. Medial oblique, best for calcaneonavicular coalition
3. Inversion, plantarflexion: Bifrucate ligament
4. Plantarflexion, Inversion
5. Prior ankle sprain, Osteoprosis and Smoking
What tx would you use for this ankle fracture?
What are the goals of tx 2?
1. Short-leg non-weight bearing cast for 4-6 weeks
- Creating a relatively normal foot shape to allow use of normal footwear
- Ensuring correct alignment
- Establishing articular congruity to promote pain-free function
- Prevent long-term degenerative change.
Sander's classification (Exam):
• Type I – undisplaced fractures
• Type II – two-part or split fractures
• Type III– three-part or split depression fracture
• Type IV – four-part or highly comminuted articular fractures.
What imaging view shows the widest part of the posterior facet?
Three primary fracture lines divide calcanues into 3 sections:
All non-displaced articular fracture (<2mm) irrespective of the number of fracture line
Type 2 non-union:
1. Two part fracture of the posterior facet
2. IIA, IIB, IIC
Type II non-union
1. Two-part fracture of the posterior facet
2. IIA, IIB, IIC
Type III AC
1. three part fracture with a centrally depressed fragment
Type III BC
1. Four-part articular fractures; highly communited
Type I :
Ia: Fracture of calcaneus tuberosity
Ib: Fracture of sustentaculum tali
Ic: Fracture of anterior process
Avulsion fracture involving Achilles tendon
Fracture of the body not involving the subtalar joint
Fracture involving subtalar joint
Central depression fracture into the subtalar joint
Type 1 ?
Type 1: Fractures not involving subtalar joint
Type 2: Fractures involving subtalar joint
Type 1. Fractures not involving the subtalar joint
A: Tuberosity fracture
B: Fractures only involving the calceneocuboid joint
Type 2. Fractures involving the subtalar joint
A. Without displacement
B. With displacement