Calcaneus fracture

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Background

  • 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

Foot and Toe Fractures

Hindfoot

Midfoot

Forefoot

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)

Treatment & Disposition

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

See Also

Video

References