Calcaneus fracture: Difference between revisions
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==Background== | ==Background== | ||
[[File:Foot_Bones.jpg|thumb|Bones of the foot.]] | |||
*Associated injuries are common | *Associated injuries are common | ||
== | ===Types=== | ||
* | *Intra-articular (75%) | ||
** | **Sclerotic line may be only evidence of impacted fracture | ||
*Extra-articular (25%) | |||
**Anterior process fracture is most common | |||
== | ==Clinical Features== | ||
*( | *Foot pain after [[Trauma (main)|trauma]] - often from axial load such as fall from height or motor vehicle accident | ||
== | ==Differential Diagnosis== | ||
*Intra-articular fracture | {{Foot and toe fractures DDX}} | ||
==Evaluation== | |||
[[File:Boehlers_Angle.jpg|thumb|(A) Normal Boehler's angle and (B) Abnormal Boehler's angle]] | |||
*Plain X-ray imaging | |||
**Decreased Boehler's angle (<25') may be only sign of fracture (compare with opposite side) | |||
**Harris view to tuberosity | |||
*Up to half of patients with calcaneus fractures have concomitant injuries including compression fractures of thoracolumbar spine <ref>Sanders RW, Clare MP. Calcaneous fractures. In: Rockwood and Green's Fractures in Adults, 7th, Bucholz, RW, Heckman JD, Court-Brown CM, Tornetta P (Eds), Lippincott Williams & Wilkins, Philadelphia 2010. p.2064.</ref> | |||
==Management & Disposition== | |||
{{General Fracture Management}} | |||
===Intra-articular fracture=== | |||
*Immobilization with [[posterior ankle splint]] | |||
*Non-weight bearing | |||
*Elevation (very important - fracture has high rate of severe swelling) | |||
*Ortho consult | |||
===Extra-articular fracture=== | |||
*Immobilization with [[posterior ankle splint]] | |||
*Close ortho follow up | |||
==See Also== | ==See Also== | ||
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*[[Foot Diagnoses (Main)]] | *[[Foot Diagnoses (Main)]] | ||
== | ==References== | ||
<references/> | |||
[[Category: | [[Category:Orthopedics]] | ||
Latest revision as of 15:42, 10 April 2024
Background
- Associated injuries are common
Types
- Intra-articular (75%)
- Sclerotic line may be only evidence of impacted fracture
- Extra-articular (25%)
- Anterior process fracture is most common
Clinical Features
- Foot pain after trauma - often from axial load such as fall from height or motor vehicle accident
Differential Diagnosis
Foot and Toe Fracture Types
Hindfoot
Midfoot
Forefoot
Evaluation
- Plain X-ray imaging
- Decreased Boehler's angle (<25') may be only sign of fracture (compare with opposite side)
- Harris view to tuberosity
- Up to half of patients with calcaneus fractures have concomitant injuries including compression fractures of thoracolumbar spine [1]
Management & Disposition
General Fracture Management
- Acute pain management
- Open fractures require immediate IV antibiotics and urgent surgical washout
- Neurovascular compromise from fracture requires emergent reduction and/or orthopedic intervention
- Consider risk for compartment syndrome
Intra-articular fracture
- Immobilization with posterior ankle splint
- Non-weight bearing
- Elevation (very important - fracture has high rate of severe swelling)
- Ortho consult
Extra-articular fracture
- Immobilization with posterior ankle splint
- Close ortho follow up
See Also
References
- ↑ Sanders RW, Clare MP. Calcaneous fractures. In: Rockwood and Green's Fractures in Adults, 7th, Bucholz, RW, Heckman JD, Court-Brown CM, Tornetta P (Eds), Lippincott Williams & Wilkins, Philadelphia 2010. p.2064.