Beginner’s guide to Calcaneal Fractures

A crash course regarding calcaneal fractures.

 

Last edited: March 2016

Author: Rossi bad

The most fractured bone of all the tarsal bones is the calcaneus. They are mostly intra-articular and closed.

There are 3 common “types” of fractures as it relates to the calcaneus:

  1. Intra-articular: Primary fx line (oblique-shearing) results in two fx: superio-medial (constant fragment) and superolateral (posterior facet) fragments. Secondary fx line results in either tongue-type or joint depression.
  2. Extra-articular: gastroc-soleus avulsion fracture
  3. Anterior process fx: inversion/plantarflexion results bifurcate avulsion fx.

 

Common associated terms:

  1. Essex-Lopresti classification
  2. Rowe classification
  3. Sanders classification
  4. Degan classification
  5. Tongue type vs joint depression
  6. Gissane’s angle
  7. Bohler’s angle
  8. Constant fragment
  9. Harris view
  10. Broden view
  11. Shear fracture of Palmer
  12. Mondor’s sign

 

Pearls:

  1. Most commonly fractured tarsal bone? calcaneus
  2. Most important surgical concept in the surgical reduction of calcaneal fractures? elevate the posterior facet
  3. Rowe Class IV corresponds to Essex Lopresti

 

References

  1. http://www.orthobullets.com/trauma/1051/calcaneus-fractures

Podiatry Classifications – Mnemonics, vignettes, easy ways to remember

The following is a table of common podiatry classifications. They do not describe the classification in detail, but serves    …..as a stepping stone. It is paramount that you first know what the system describes.

 

Classification
How to remember
Jahss  (1st MPJ dislocation) “JahSeS-amoid”
Watson-Jones (navicular) “Watsaw [the] navicular”
Rowe (calcaneus – extraarticular) “go out and Rowe [your boat] in the Essex river”

the calcaneus looks like a boat too! out = extraarticular, in = intraarticular.

Essex-Lopresti (calcaneus – intraarticular) “see above.”

Out of the types of calcaneal classifications (Rowe, Sanders, Essex-lopreseti) it has TWO words=> 2 types of essex-lopresti

Bernt-Hardy (talar dome lesions) “talar dome lesions are hard to see”

talar dome lesions are commonly missed on normal radiographs (50%)

Lauge-Hansen (ankle fx) “Large-hansen”

refers to ankle fractures! the ankle is large compared other classifications. you prob. should know this classification anyways.

Hardcastle (lis-franc) “queen lis-abeth [and king frank] lives in a castle. ”

if you remember the above, then you can associate QUENU (sounds like queen with this classification. recall that hardcastle elaborated on quenu)

the met's look like a castle's gate
the met’s look like a castle’s gate
Sanders (CT calcaneus) “FEEL THE BERN…from the CT machine”

CT would most likely be used for intra-articular fractures, so this is an intra-articular classification, for the calcaneus. Say it with me: Feel the bern of the coronal CT of the calcaneus –lol?

Danis-Weber (fibula fx) Danis-Weber goes with Salter-Harris. Remember the ABCDanis -Weber. Visualize three locations (A,B,C) with respect to the ankle mortise. Since the mortise involves the tibia, these fractures have to be wrt the FIBULA.
Salter-Harris (tibia fx) See above. S-same SalTEr- TIBIAL EPIPHYSEALradiopaedia.