The lateral calcaneal artery provides blood supply to the lateral flap associated with the calcaneal extensile approach.
#Calcaneus fracture orthobullets plus#
Subtalar distraction arthrodesis plus insertion of a bony block and rigid internal fixation Some surgeons advocate conservative treatment of the calcaneus. Joint depression type usually needs open reduction. Tongue-type fracture may benefit from closed reduction and percutaneous fixation or open reduction and internal fixation. Surgery decreases the risk of post-traumatic arthritis. Occurs more in smokers, diabetics and in patients with open fractures.Ģ-Open fractures of the calcaneus-May lead to amputation & there is a high risk of infection.Ĥ-Peroneal tendon irritation and impingement from the lateral wall. Will see a fracture in T1 as a linear streak or a band of low signal intensity in the posterior calcaneal tuberosity.ġ-Wound-related complications are the most common complications (20%).Positive squeeze test could mean there is a stress fracture of the calcaneus. Tenderness with medial and lateral compression of the hindfoot.Stress fracture of the calcaneus may be misdiagnosed as plantar fasciitis. A decrease in this angle indicates the collapse of the posterior facet. 0-degree Bohler angle: measured on lateral x-ray (Harris view and axial view)īohler angle is formed by a line drawn from the highest point of the anterior process of the calcaneus to the highest point of the posterior facet and a line drawn tangential to the superior edge of the tuberosity.Patient has a simple fracture pattern.Young females less than 40 years of age.
Calcaneal fractures are better if the patient is a female. Men do worse with calcaneal fractures than women. Factors associated with poor outcome are: May be seen as an avulsion fracture of the fibula on x-rays.Ĭomplication rate is high.
#Calcaneus fracture orthobullets skin#
Open reduction and internal fixation of the calcaneus is generally delayed for 1-2 weeks to allow for improvement of the soft tissue swelling, except with fractures of the posterior tuberosity (avulsion fracture) which can cause skin tenting and urgent reduction is recommended. Do not wait, do emergency surgery.įor joint depression fracture, wait for swelling to go down before surgery. Avulsion fracture of the calcaneus is an emergency. Calcaneal avulsion fractures need urgent reduction and internal fixation to prevent skin complications.
Type III usually gets more arthritis because it has more fracture fragments and may end by fusion. Sander’s type II & type III calcaneal fractures will benefit from surgery of reduction and fixation. Type III-Three-part fracture of the posterior facet. Type II-Two-part fracture of the posterior facet. Type I- Nondisplaced/Non-operative treatment The flexor hallucis longus tendon lies underneath the sustentaculum and if screw placement to the sustentacular fragment is too long, this could affect the flexor hallucis longus tendon, causing fixed flexion of the big toe. Superomedial fragment includes the sustentaculum tali and it is stabilized to the talus by ligaments. The primary fracture line divides the calcaneus into two main fragments. The primary fracture line goes from anterolateral to posteromedial. The primary fracture line is caused by an axial load injury. Ebraheim’s educational animated video describes fracture of the calcaneus - heel bone.įractures of the calcaneus could be open or closed.
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