Exam II Lecture 7 Calcaneal Fractures Dr. Smith

Question 1

What is a normal Bohlers angle?

Answer 1

25-40

Question 2

What other area of the body should be imaged with calcaneal fractures?

Answer 2

Lumbar spine films
T12- L2
Most commonly L1 is damaged via a compression fracture.

Question 3

What is the most important view for calcaneal fractures?

Answer 3

Calcaneal axial to check for calaneal height and width/varus.

Question 4

what does Bohler’s Angle measure?

Answer 4

Intra-articular depression of the calcaneus posterior facet.

Normally 25-40 degrees.

Question 5

What does Gissanes crucial angle evaluate?

Answer 5

Relationship of the articular facets.

Created by the subchondral bone of the posterior facet and the subchondral bone of the anterior and middle facets.

Question 6

What is the normal Gissane’s crucial angle?

Answer 6

120-145

Question 7

What is Mondor’s Sign?

Answer 7

Ecchymosis medial and plantar

Highly indicative of a calcaneal fracture.

Question 8

What does the Rowe Classification system check?

Answer 8

Extra-articular calcaneal fractures with the exception of one.

Question 9

Row 1a

Answer 9

Fracture of the calcaneal tubercle

Question 10

Rowe 1b

Answer 10

Fracture of the sustentaculum tali

Question 11

Rowe 1C

Answer 11

Fracture of the calcaneal anterior process

Question 12

Rowe IIa

Answer 12

Beak fracture of calcaneal tuberosity *Spares the achilles tendon

Question 13

Rowe IIb

Answer 13

Avulsion fracture of the calcaneal tuberosity involving the achilles tendon!!!

Question 14

Rowe III

Answer 14

Oblique body fracture NOT INVOLVING STJ

Question 15

Rowe IV

Answer 15

Calcaneal Body Fracture involving the STJ

Question 16

Rowe V

Answer 16

Calcaneal Joint depression with comminution.

Question 17

Which Rowe fracture type is the first stage in a joint depression fracture?

Answer 17

A Rowe 1b in which the sustentaculum tali has a fracture present.

you will see pain when flexing hallucis longus.

Question 18

What is the most common Rowe Type 1 fracture (A,C,B)

Answer 18

Type 1C which is a fracture through the anterior process of the calcaneus. Most common with supination and plantarflexion.

Question 19

Describe the Essex-Lopresti Tongue type fracture

Answer 19

Primary fracture line separating sustentaculum tali from lateral calcaneus.

Secondary Fracture line goes through the tuberosity.

This is most commonly called a lateral wall blow out.

Question 20

what imagery is used to determine the Sanders Classification?

Answer 20

CT looking at the widest part of the posterior facet.

Three lines separate the calcaneus into four parts A-C from lateral to medial.

Question 21

Sanders Type 1

Answer 21

All nondisplaced intrarticular calcaneal fractures are type 1 irrespective of the number of fracture lines.

Question 22

Sanders Type 2 fracture

Answer 22

These are displaced two part fractures of the posterior facet of the calcaneus

they are named IIA,IIB,IIC based on where the primary fracture line is placed.

**C involves the sustentaculum tali

Question 23

Sanders III

Answer 23

Three part calcaneal fracture of the posterior facet.

Features a centrally depressed fragment!!!

Ex: Type IIIAB, IIIAC etc

Question 24

Sanders IV

Answer 24

Four part fracture that is highly comminuted with more than four fragments typically.

Joint depression will be present here.