Flashcards in Calcaneus Fractures Deck (11):
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.
How often do open injuries and compartment syndrome occur with calcaneus fractures?
Compartment syndrome: 10%
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°)
What is the classification of calcaneus fractures?
1) Tounge type
2) Joint depression
Based on CT scans that use 3 fracture lines to divide into 4 fragments (lateral, middle, medial, sustentaculum tali)
II- 2 part fractures of the posterior facet
III- 3 part fractures with central depression
IV- 4 part articular, comminuted
What is indicated in a patient with suspected stress fracture of the calcaneus?
Cast immobilization for 6 weeks
What factors are a/w poor outcomes in calcaneal fractures?
1) age > 50
3) manual labor
4) workers comp
6) bilateral calcaneal fractures
7) multiple trauma
9) men do worse with surgery than women
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
What factors increase the risk of wound complications in calcaneal fractures?
3) Open injuries
During ORIF of calcaneal fractures, what structure is at risk with placement of lateral to medial screws, especially at level of sustentaculum tali?
the great toe will be in a fixed, flexed position from the tendon being tethered over a screw.
Non-operative treatment of displaced intra-articular calcaneal fractures require late subtalar fusion for post-traumatic arthritis in what percentage of patients?