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Flashcards in Calcaneus Fractures Deck (11):
1

What are the two main fragments of calcaneus fractures?

Fracture moves from plantar medial to dorsal lateral, producing two main fragments: the sustentacular (anteromedial) and tuberosity (posterolateral) fragments.

2

How often do open injuries and compartment syndrome occur with calcaneus fractures?

Open: 10-15%
Compartment syndrome: 10%

3

What are two radiographic measures of the calcaneus?

Bohler's angle: anterior process to posterior facet, posterior facet to calcaneal tuberosity (normal is 20-40°)
Gissane's angle: angle of the posterior facet (normal 105-135°)

4

What is the classification of calcaneus fractures?

Essex-Lopresti:
1) Tounge type
2) Joint depression

Sanders:
Based on CT scans that use 3 fracture lines to divide into 4 fragments (lateral, middle, medial, sustentaculum tali)
I- Nondisplaced
II- 2 part fractures of the posterior facet
III- 3 part fractures with central depression
IV- 4 part articular, comminuted

5

What is indicated in a patient with suspected stress fracture of the calcaneus?

MRI
Cast immobilization for 6 weeks

6

What factors are a/w poor outcomes in calcaneal fractures?

1) age > 50
2) obesity
3) manual labor
4) workers comp
5) smokers
6) bilateral calcaneal fractures
7) multiple trauma
8) vasculopathies
9) men do worse with surgery than women

7

In ORIF of calcaneal fractures, what factors are a/w increased risk of secondary subtalar fusion?

male worker's compensation patient who participates in heavy labor work with an initial Böhler angle less than 0 degrees

8

What factors increase the risk of wound complications in calcaneal fractures?

1) Smokers
2) diabetics
3) Open injuries

9

During ORIF of calcaneal fractures, what structure is at risk with placement of lateral to medial screws, especially at level of sustentaculum tali?

FHL;
the great toe will be in a fixed, flexed position from the tendon being tethered over a screw.

10

Non-operative treatment of displaced intra-articular calcaneal fractures require late subtalar fusion for post-traumatic arthritis in what percentage of patients?

16%

11

What factors are a/w better outcomes with ORIF vs non-operative treatment for intra-articular calcaneal fractures?

1) Women
2) Not worker's comp
3) Age