Calcaneal fractures can be intraarticular and extraarticular fractures. Extra articular fractures. Anterior process fracture. It results from forced plantar flexion and inversion. is fracture is frequently missed and misdiagnosed as an ankle sprain. Treatment is usually conservative and surgery is done only in cases of displaced large fragments. Extra-articular fracture of e calcaneus involving e posterior tuberosity of e calcaneus not reaching e subtalar joint. Intact Achilles tendon. An accidental finding of . Extra-articular – Around 25 of calcaneal fractures Commonly are avulsion fractures, wi sparing of e articular surface of subtalar joint, including avulsion of e calcaneal tuberosity by e Achilles tendon Management can be guided by is classification (Table 1), as intra-articular fractures will likely require definitive fixation5/5. Intra-articular fracture. Immobilization wi posterior ankle splint. Non-weight bearing. Elevation (very important - fracture has high rate of severe swelling) Or o consult. Extra-articular fracture. Immobilization wi posterior ankle splint. Close or o follow up. See Also. Foot Fractures. Foot Diagnoses (Main) Video. Epidemiology. e calcaneus is e most commonly fractured tarsal bone and accounts for about 2 of all fractures 2 and ~60 of all tarsal fractures 3.. Pa ology. Calcaneal fractures can be divided broadly into two types depending on whe er ere is articular involvement of e subtalar joint 2,7,8. extra-articular: 25-30. dictate whe er ere is joint depression or tongue-type fracture. extra-articular fractures. strong contraction of gastrocnemius-soleus wi concomitant avulsion at its insertion site on calcaneus. more common in osteopenic/osteoporotic bone. anterior process fractures. inversion and plantar flexion of e foot cause avulsion of e bifurcate. Extra-articular: twisting force, avulsion injury. X-ray: 종골 골절(Calcaneal fracture) - Lateral view.. Flattening of Bohler's angle. 2. Depression of e articular surface of e posterior subtalar joint (red line) from its normal position (green line) 3. Fracture lines can be seen passing rough e calcaneus. Finally, an isolated extra-articular fracture of e medial process of e calcaneus has also been reported (Fig. 1b).7,12 Our aim is to describe our experience wi fractures of e tuberosity of e calcaneus. We will deﬁne e different Diagram of e fractures of e calcaneal tuberosity showing a) an extra-articular avulsion fracture. Calcaneal Achilles Avulsion Fracture: Clinical Practice Guideline. Background. Avulsion fractures of e posterior calcaneal tuberosity are rare injuries. wi a prevalence of 1-3 of all calcaneal fractures. is type of extra-articular fracture is typically e result of twisting forces in e hindfoot. 08, · Most extraarticular fractures are treated conservatively wi -12 weeks of casting (true extra-articular fractures only account for roughly 20 of all calcaneal fractures) Calcaneal tuberosity avulsion displaced sustentaculum tali, and large substantial calcaneal body fractures require operative management. Dr. Ebraheim’s educational animated video describes e calcaneal extra-articular fractures. Follow me on twitter: https://twitter.com/!/DrEbraheim_UTMC Cal. Apr 09, · An extra-articular calcaneal fracture can be an anterior process fracture. ese fractures results from forced plantar flexion and inversion. ey are commonly missed and/or misdiagnosed as an. 16, · Classification: Extra VS Intra-articular - Extra-articular - Avulsion fracture: calcaneal tuberosity, anterior process by bifurcate ligament, sustentaulum tali - Intra-articular 35. Classification: Based on Plain film Es-Lopresti P. e mechanism, reduction technique, and results in fractures of e os calcis. Br J Surg. 1952.39:395–419. bo intra and extra articular calcaneal fractures remains an acceptable mode of treatment wi a satisfactory functional outcome based on is mid term review. is is a cost effective option especially for hospitals wi limited financial resources and operating facilities. 1 189 NV-MOJ 08 28-32 G5H.qxd 4/29/08 4:00 PM Page 31. Fractures of e calcaneus or not involve e subtalar and surrounding joints. Fractures involving e joints (intra-articular fractures) are e most severe calcaneal fractures, and include damage to e cartilage (e connective tissue between two bones). e outlook for recovery depends on how severely e calcaneus was crushed at. 26, · CALCANEAL FRACTURETRA-ARTICULAR FRACTURES 38. EXTRA ARTICULAR FRACTURES Vertical Tuberosity Medial Process Anterior Avulsion at EDBProcess attachment 39. ANTERIOR PROCESS FRACTUREForced inversion or forced abduction &dorsiflexionBest seen on oblique viewsUsually treated wi protected weight bearing.If involving . Calcaneus Fractures Key Points: Fractures of e pediatric calcaneus are rare injuries and are frequently missed. e most common etiology is a forceful axial load to e hindfoot, frequently occurring during a fall. Calcaneus fractures in children younger an years of age, are usually extra-articular. Calcaneal fracture - Calcaneal fractures are e most common tarsal fractures and are often difficult to detect on radiographs Bohler’s angle (calculated by drawing tangent lines along e anterior and posterior upper gins of e calcaneus on a lateral radiograph, as shown in e annotated images below) calcaneal fracture and can be useful. Intra-articular tongue-type fractures of e calcaneus: anatomy, injury patterns, and an approach to management Eric. White 1 & Mat ew R. Skalski 2 & George R. Matcuk Jr 1 & Na anael Heckmann. extra-articular fractures are avulsion injuries arising from twisting or shearing forces. e outcome of extra-articular fractures is, on average, better an intra-articular types. e classification system was defined by Sanders, based on CT scan findings (5). e optimal treatment of intra-articular fractures of e calcaneus is under debate. e fracture fragment often is small and extra-articular, occurring as a plantarflexion and inversion force tensions e bifurcate ligament, which overcomes e attachment of e distal-most calcaneus. Alternatively, compressive injuries occur wi sudden abduction . Fractures involving e joints (intra-articular fractures) are e most severe calcaneal fractures, and include damage to e cartilage (e connective tissue between two bones). e outlook for recovery depends on how severely e calcaneus was crushed at e time of injury. Fractures at don’t involve e joint (extra-articular fractures. Extra-articular calcaneal fractures are treated symptomatically wi protection, rest (avoiding weight bearing), a compression dressing (which also provides protection), ice, and elevation. When e swelling resolves, a cast is applied. To diagnose and evaluate a calcaneal fracture, e foot and ankle surgeon will ask questions about how e injury occurred,examine e affected foot and ankle,and order x-rays. In addition,advanced imaging tests are commonly required. FRACTURES OF E CALCANEUS (HEEL BONE FRACTURES) Achilles avulsion Stress fracture Extra-articular fractures. Objective: A minimally invasive technique to prevent soft tissue problems using a calcaneal nail (Calcanail, FH Or opedics, Heimsbrunn, France) for calcaneal fractures or in subtalar joint ar rodesis is described. Indications: Displaced extra-articular calcaneal fractures involving e tuberosity fragment and in displaced intra-articular calcaneal fractures wi impression and/or. Intra-articular fractures are more common and involve e posterior talar articular facet of e calcaneus. e Sanders classification groups ese fractures into four types based on e location of e fracture at e posterior articular surface. Extra-articular fractures are less common and be located anywhere outside e subtalar joint. Extra-articular fractures comprise 25 to 30 and intraarticular fractures account for 70 to 75 of all adult calcaneal fractures. e Pre-CT classifications, understandably limited, offer e primitive distinction between outcomes of intra-articular versus extra-articular fractures, which was originally made by Es-Lopresti (14). O 8 calcaneal fractures at occurred during is period, 18 were non-displaced extra-articular fractures and 30 were displaced intra-articular fractures. An independent evaluator contacted each patient and performed chart reviews regarding e work history, period of . **Relatively high rates of angulation, translation, and fracture diastasis of e sustentaculumn tali in intra-articular calcaneal fractures wi ORIF, us e use of medial approach and e use of a combined approach have previously been reported in literature, wi favorable results. Fractures involving e joints (intra-articular fractures) are e most severe calcaneal fractures and include damage to e cartilage (e connective tissue between two bones). e outlook for recovery depends on how severely e calcaneus was crushed at e time of injury. Fractures at do not involve e joint (extra-articular fractures. All operative calcaneal fractures treated between - by fellowship trained or opaedic trauma surgeons were evaluated. ose wi bo post-operative CT scans and radiographs were included. Exclusion criteria included extra-articular fractures, malunions, percutaneous fixation, ORIF and pri y fusion, and ose patients wi out. A calcaneal body fractures is e most frequent extra-articular fracture. O er extra-articular fractures include ose targeting e anterior process, e superior tuberosity beak, e sustentaculum tali and avulsions. Anterior process fractures are e only fractures seen more commonly in women and make up about to 15 of all extra. Extra-articular calcaneal fractures should be treated wi a bulky compression dressing, rest, ice, and elevation. Arrange or opedic follow-up care. Extra-articular fractures-fractures of e postero-superior angle-fractures of e calcaneal tuberosity-fractures of e plantar tuberosities -fractures of e great apophysis. is classification was heavily used in clinical practice, but e lack of e fracture pattern description led to . Al ough operative treatment of displaced, intra-articular fractures of e calcaneus in adults is generally accepted as standard practice, operative treatment for e same fractures in e skeletally immature remains controversial, potentially because e outcome for fracture types (intra- vs. extra-articular) and severity (displaced vs. nondisplaced) have been confounded in studies of children. 1. Introduction. Calcaneal fractures in children are comparatively rarer an in adults, making up around 0.005 of all fractures reported .Treatment is usually conservative. however, open reduction and internal fixation are often used to manage displaced or intra-articular fractures. 28, · Intra-articular fractures are more common and involve e posterior talar articular facet of e calcaneus. e Sanders classification groups ese fractures into four types based on e location of e fracture at e posterior articular surface. Extra-articular fractures are less common and be located anywhere outside e subtalar joint. . What percentage of calcaneal fractures are INTRA-articular? 75. Calcaneal fractures often occur after falling from what height? 6 ft. Peak incidence of calcaneal fractures is at what age? 2. rowe-extra-articular fxs. What ligament injury is often associated wi anterior process of calcaneal . 01, · Avulsion fractures of e calcaneal tuberosity (extra-articular or beak fractures) are rare, accounting for 1 to 3 of all calcaneal fractures [1-3]. ese injuries are typically caused by a violent concentric contraction of e gastrocnemius soleus muscle complex after a stumble or fall [1-4].