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Intra-articular Calcaneal Fractures

  • Kenneth L. KouryEmail author
Chapter
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Abstract

Calcaneal fractures are potentially devastating injuries. Effective treatment of these fractures requires an understanding of the calcaneus anatomy as well as surgical techniques to restore normal biomechanics. The purpose of this chapter is to discuss the anatomy, classification, treatment rationale, as well as treatment options for heel bone fractures. Additionally, this chapter reviews the important elements of calcaneal fracture treatment by describing the operative fixation of two distinct types of calcaneus fractures. This chapter reviews fixation of a tongue type fracture as well as joint depression fracture. Through these cases, the reader will gain a better understanding of the key aspects of heel bone anatomy and biomechanics that affect these distinct fracture patterns. Additionally, the reader will gain insight into the different temporizing management techniques, surgical approaches, and definitive management techniques for these discrete fracture patterns.

Keywords

Calcaneus fracture Calcaneus fixation Heel bone fracture Tongue type Joint depression type 

References

  1. 1.
    Mitchell MJ, McKinley JC, Robinson CM. The epidemiology of calcaneal fractures. Foot (Edinb). 2009;19(4):197–200.CrossRefGoogle Scholar
  2. 2.
    Barei DP, Bellabarba C, Sangeorzan BJ, Benirschke SK. Fractures of the calcaneus. Orthop Clin North Am. 2002;33(1):263–85. xCrossRefGoogle Scholar
  3. 3.
    Sanders R. Displaced intra-articular fractures of the calcaneus. J Bone Jt Surg Am Vol. 2000;82(2):225–50.CrossRefGoogle Scholar
  4. 4.
    Benirschke SK, Sangeorzan BJ. Extensive intraarticular fractures of the foot. Surgical management of calcaneal fractures. Clin Orthop Relat Res. 1993;292:128–34.CrossRefGoogle Scholar
  5. 5.
    Thordarson DB, Krieger LE. Operative vs. nonoperative treatment of intra-articular fractures of the calcaneus: a prospective randomized trial. Foot Ankle Int. 1996;17(1):2–9.CrossRefGoogle Scholar
  6. 6.
    Zwipp H, Tscherne H, Thermann H, Weber T. Osteosynthesis of displaced intraarticular fractures of the calcaneus. Results in 123 cases. Clin Orthop Relat Res. 1993;290:76–86.Google Scholar
  7. 7.
    Brauer CA, Manns BJ, Ko M, Donaldson C, Buckley R. An economic evaluation of operative compared with nonoperative management of displaced intra-articular calcaneal fractures. J Bone Jt Surg Am Vol. 2005;87(12):2741–9.CrossRefGoogle Scholar
  8. 8.
    Sanders R, Fortin P, DiPasquale T, Walling A. Operative treatment in 120 displaced intraarticular calcaneal fractures. Results using a prognostic computed tomography scan classification. Clin Orthop Relat Res. 1993;290:87–95.Google Scholar
  9. 9.
    Buckley R, Tough S, McCormack R, et al. Operative compared with nonoperative treatment of displaced intra-articular calcaneal fractures: a prospective, randomized, controlled multicenter trial. J Bone Joint Surg Am. 2002;84-A(10):1733–44.CrossRefGoogle Scholar
  10. 10.
    Stephenson JR. Surgical treatment of displaced intraarticular fractures of the calcaneus. A combined lateral and medial approach. Clin Orthop Relat Res. 1993;290:68–75.Google Scholar
  11. 11.
    Burdeaux BD. Calcaneus fractures: rationale for the medial approach technique of reduction. Orthopedics. 1987;10(1):177–87.PubMedGoogle Scholar
  12. 12.
    Sangeorzan BJ, Mosca V, Hansen ST Jr. Effect of calcaneal lengthening on relationships among the hindfoot, midfoot, and forefoot. Foot Ankle. 1993;14(3):136–41.CrossRefGoogle Scholar
  13. 13.
    Essex-Lopresti P. The mechanism, reduction technique, and results in fractures of the os calcis. Br J Surg. 1952;39(157):395–419.CrossRefGoogle Scholar
  14. 14.
    Carr JB, Hamilton JJ, Bear LS. Experimental intra-articular calcaneal fractures: anatomic basis for a new classification. Foot Ankle. 1989;10(2):81–7.CrossRefGoogle Scholar
  15. 15.
    Wulker N, Zwipp H, Tscherne H. Experimental study of the classification of intra-articular calcaneus fractures. Unfallchirurg. 1991;94(4):198–203.PubMedGoogle Scholar
  16. 16.
    Gardner MJ, Nork SE, Barei DP, Kramer PA, Sangeorzan BJ, Benirschke SK. Secondary soft tissue compromise in tongue-type calcaneus fractures. J Orthop Trauma. 2008;22(7):439–45.CrossRefGoogle Scholar
  17. 17.
    Böhler L. Diagnosis, pathology, and treatment of fractures of the os calcis. J Bone Jt Surg. 1931;13:75–89.Google Scholar
  18. 18.
    Gissane W. Discussion on “fractures of the os calcis.” in proceedings of the British Orthopaedic Association. J Bone Jt Surg. 1947;29:254–5.Google Scholar
  19. 19.
    Crosby LA, Fitzgibbons T. Computerized tomography scanning of acute intra-articular fractures of the calcaneus. A new classification system. J Bone Jt Surg Am. 1990;72(6):852–9.CrossRefGoogle Scholar
  20. 20.
    Mehta S, Mirza AJ, Dunbar RP, Barei DP, Benirschke SK. A staged treatment plan for the management of type II and type IIIA open calcaneus fractures. J Orthop Trauma. 2010;24(3):142–7.CrossRefGoogle Scholar
  21. 21.
    Benirschke SK, Kramer PA. Wound healing complications in closed and open calcaneal fractures. J Orthop Trauma. 2004;18(1):1–6.CrossRefGoogle Scholar
  22. 22.
    Fakhouri AJ, Manoli A 2nd. Acute foot compartment syndromes. J Orthop Trauma. 1992;6(2):223–8.CrossRefGoogle Scholar
  23. 23.
    Myerson M, Manoli A. Compartment syndromes of the foot after calcaneal fractures. Clin Orthop Relat Res. 1993;290:142–50.Google Scholar
  24. 24.
    Varela CD, Vaughan TK, Carr JB, Slemmons BK. Fracture blisters: clinical and pathological aspects. J Orthop Trauma. 1993;7(5):417–27.CrossRefGoogle Scholar
  25. 25.
    Giordano CP, Koval KJ. Treatment of fracture blisters: a prospective study of 53 cases. J Orthop Trauma. 1995;9(2):171–6.CrossRefGoogle Scholar
  26. 26.
    Walters JL, Gangopadhyay P, Malay DS. Association of calcaneal and spinal fractures. J Foot Ankle Surg. 2014;53(3):279–81.CrossRefGoogle Scholar
  27. 27.
    Worsham JR, Elliott MR, Harris AM. Open calcaneus fractures and associated injuries. J Foot Ankle Surg. 2016;55(1):68–71.CrossRefGoogle Scholar
  28. 28.
    Broden B. Roentgen examination of the subtaloid joint in fractures of the calcaneus. Acta Radiol. 1949;31(1):85–91.CrossRefGoogle Scholar
  29. 29.
    Tufescu TV, Buckley R. Age, gender, work capability, and worker's compensation in patients with displaced intraarticular calcaneal fractures. J Orthop Trauma. 2001;15(4):275–9.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Orthopaedic Trauma SurgeryGeisinger Wyoming ValleyWilkes-BarreUSA

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