Exam II Lecture 7 Calcaneal Fractures Dr. Smith Flashcards
What is a normal Bohlers angle?
25-40
What other area of the body should be imaged with calcaneal fractures?
Lumbar spine films
T12- L2
Most commonly L1 is damaged via a compression fracture.
What is the most important view for calcaneal fractures?
Calcaneal axial to check for calaneal height and width/varus.
what does Bohler’s Angle measure?
Intra-articular depression of the calcaneus posterior facet.
Normally 25-40 degrees.
What does Gissanes crucial angle evaluate?
Relationship of the articular facets.
Created by the subchondral bone of the posterior facet and the subchondral bone of the anterior and middle facets.
What is the normal Gissane’s crucial angle?
120-145
What is Mondor’s Sign?
Ecchymosis medial and plantar
Highly indicative of a calcaneal fracture.
What does the Rowe Classification system check?
Extra-articular calcaneal fractures with the exception of one.
Row 1a
Fracture of the calcaneal tubercle
Rowe 1b
Fracture of the sustentaculum tali
Rowe 1C
Fracture of the calcaneal anterior process
Rowe IIa
Beak fracture of calcaneal tuberosity *Spares the achilles tendon
Rowe IIb
Avulsion fracture of the calcaneal tuberosity involving the achilles tendon!!!
Rowe III
Oblique body fracture NOT INVOLVING STJ
Rowe IV
Calcaneal Body Fracture involving the STJ
Rowe V
Calcaneal Joint depression with comminution.
Which Rowe fracture type is the first stage in a joint depression fracture?
A Rowe 1b in which the sustentaculum tali has a fracture present.
you will see pain when flexing hallucis longus.
What is the most common Rowe Type 1 fracture (A,C,B)
Type 1C which is a fracture through the anterior process of the calcaneus. Most common with supination and plantarflexion.
Describe the Essex-Lopresti Tongue type fracture
Primary fracture line separating sustentaculum tali from lateral calcaneus.
Secondary Fracture line goes through the tuberosity.
This is most commonly called a lateral wall blow out.
what imagery is used to determine the Sanders Classification?
CT looking at the widest part of the posterior facet.
Three lines separate the calcaneus into four parts A-C from lateral to medial.
Sanders Type 1
All nondisplaced intrarticular calcaneal fractures are type 1 irrespective of the number of fracture lines.
Sanders Type 2 fracture
These are displaced two part fractures of the posterior facet of the calcaneus
they are named IIA,IIB,IIC based on where the primary fracture line is placed.
**C involves the sustentaculum tali
Sanders III
Three part calcaneal fracture of the posterior facet.
Features a centrally depressed fragment!!!
Ex: Type IIIAB, IIIAC etc
Sanders IV
Four part fracture that is highly comminuted with more than four fragments typically.
Joint depression will be present here.
