Calcaneus fracture

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

Differential Diagnosis

Foot and Toe Fracture Types

Hindfoot

• Talus fracture
• Calcaneus fracture

Midfoot

• Lisfranc injury
• Navicular fracture
• Cuboid fracture
• Cuneiform fracture

Forefoot

• Fifth metatarsal fracture
• Non-fifth metatarsal fracture
• Toe fracture

Diagnosis

• Plain X-ray imaging
  • Decreased Boehler's angle (<25') may be only sign of fracture (compare w/ opposite side)

Images

• (A) Normal Boehler's angle and (B) Abnormal Boehler's angle

Boehler's angle

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
  • Immobilization with Posterior Ankle Splint
  • Close ortho follow up

See Also

• Foot Fractures
• Foot Diagnoses (Main)

Video

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