Calcaneus fracture
Background
Bones of the foot.
- 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
Evaluation
(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 [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
- Foot Fractures
- Foot Diagnoses (Main)
Video
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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.
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