Calcaneal fractures are usually associated with which type of situation?
Fall from height
Calcaneal fractures can be extra-articular or involve which joint?
If there is a calcaneal fracture, the heel tends to drift into which position?
Due to the valgus drift after a calcaneal fracture, which problems arise with the lateral ankle tendons?
What is the main treatment for calcaneal fractures and why is this controversial?
May be difficult to achieve skin coverage, wound healing issues especially if a smoker, diabetes etc.
Fractures of the talar neck usually occur in which scenarios?
Forced dorsiflexion of foot from rapid deceleration
If a talar neck fracture is displaced, what does it involve?
Subluxation of the subtalar joint
(there may also be dislocation of the talar body from the ankle joint or the head of the talus from the talonavicular joint in high energy injuries)
Where does the talus get its blood supply?
Anastomosis involving the peroneal, anterior tibial, and posterior tibial arteries
The artery of the tarsal canal is the most vital artery within the anastomosis
Displacement, fracture, subluxation or dislocation of the talus all pose a serious risk of what?
What is the treatment of displaced fractures of the talus?
Closed or open reduction and screw fixation
What is a Lisfranc fracture-dislocation?
A fracture at the base of the 2nd metatarsal is associated with dislocation of the base of the 2nd metatarsal
(with or without dislocation of other metatarsals at the tarso-metatarsal joints)
How will a patient typically present with a Lisfranc fracture-dislocation?
- Grossly swollen foot
- Bruised foot
- Unable to weight bear
- Normal x-ray (if so, get a CT)
What is the treatment for a Lisfranc fracture-dislocation?
Open or closed reduction with fixation using screws
Which metatarsal is most commonly fractured?
What is a Jones fracture?
Fracture in the proximal diaphysis of the 5th metatarsal
Why is a Jones fracture more serious than a fracture at the base of the 5th metatarsal?
- There is relatively poor blood supply
- Risk of non-union is higher
What is the treatment for a Jones fracture?
- Displaced - fixation, usually a single screw
- Non-unions - bone grafting and fixation
The 2nd metatarsal is a common site for a ______ fracture
The 2nd metatarsal is a common site for a stress fracture
How may a fracture of the 2nd metatarsal typically come about?
- After a period of increased exercise
Why is diagnosing a stress fracture of the 2nd metatarsal difficult?
Not visible on X-ray until healing/callus has started
(bone scan may aid in the diagnosis)
Intra-articular toe fractures require which treatment?
Reduction and fixation if the fragments are sizeable
Open fractures can be stabilised with wires
How can toe dislocations be treated?
Closed reduction and either neighbor strapping or wiring