Calcanea Fracture (Pod med)

Question 1

What do you observe in this fracture?

1?

Which view 2?

Which ligament 3?

What are the possible mechanism of injury 4?

What are the predisposing conditions 5?

Answer 1

1. Avulsion fracture
2. Medial oblique, best for calcaneonavicular coalition
3. Inversion, plantarflexion: Bifrucate ligament
4. Plantarflexion, Inversion
5. Prior ankle sprain, Osteoprosis and Smoking

Question 2

What tx would you use for this ankle fracture?

1?

What are the goals of tx 2?

Answer 2

1. Short-leg non-weight bearing cast for 4-6 weeks

2.

• Creating a relatively normal foot shape to allow use of normal footwear
• Ensuring correct alignment
• Establishing articular congruity to promote pain-free function
• Prevent long-term degenerative change.

Question 3

Sander’s classification (Exam):

Type I

Type II

Type III

Type IV

Answer 3

• Type I – undisplaced fractures
• Type II – two-part or split fractures
• Type III– three-part or split depression fracture
• Type IV – four-part or highly comminuted articular fractures.

Question 4

What imaging view shows the widest part of the posterior facet?

1?

Answer 4

1. Coronal

Question 5

Three primary fracture lines divide calcanues into 3 sections:

1?

2?

3?

4?

Answer 5

1. Lateral
2. Central
3. Medial
4. Sustentacular

Question 6

Sander’s classification:

Type 1:

?

Answer 6

All non-displaced articular fracture (<2mm) irrespective of the number of fracture line

Question 7

Sander’s classification

Type 2 non-union:

1?

Subtypes 2?

Answer 7

1. Two part fracture of the posterior facet
2. IIA, IIB, IIC

Question 8

Sander’s classification

Type II non-union

1 ?

Subtypes 2?

Answer 8

1. Two-part fracture of the posterior facet
2. IIA, IIB, IIC

Question 9

Sander’s classification

Type IIA

Answer 9

Question 10

Sander Classification

Type IIB

Answer 10

Question 11

Sander’s classification

Type IIC

Answer 11

Question 12

Sander’s classification

Type III

1 ?

Type III AC

Answer 12

1. three part fracture with a centrally depressed fragment

Question 13

Sander’s classification

Type III BC

Answer 13

Question 14

Sander’s classification

Type IV

1?

Answer 14

1. Four-part articular fractures; highly communited

Question 15

Rowe classification

Type I?

Answer 15

Type I :

Ia: Fracture of calcaneus tuberosity

Ib: Fracture of sustentaculum tali

Ic: Fracture of anterior process

Question 16

Rowe Classification

Type II:

Answer 16

Beak fracture

Avulsion fracture involving Achilles tendon

Question 17

Rowe Classification

Type III:

?

Answer 17

Fracture of the body not involving the subtalar joint

Question 18

Rowe Classification

Type IV

Answer 18

Fracture involving subtalar joint

Question 19

Rowe Classification

Type V

Answer 19

Central depression fracture into the subtalar joint

Question 20

Essex-Lopresti Classification

Type 1 ?

Type 2?

Answer 20

Type 1: Fractures not involving subtalar joint

Type 2: Fractures involving subtalar joint

Question 21

Essex-Lopresti Classification

Type 1. Fractures not involving the subtalar joint

A?

B?

Answer 21

A: Tuberosity fracture

B: Fractures only involving the calceneocuboid joint

Question 22

Essex-Lopresti Classification

Type 2. Fractures involving the subtalar joint

A?

B?

Answer 22

A. Without displacement

B. With displacement