Avulsion Fracture of the Calcaneal Tuberosity: A Case Report and Literature Review

Beavis, R. Cole; Rourke, Kevin; Court-Brown, Charles M.

doi:10.3113/fai.2008.0000

Cited by 98 publications

(122 citation statements)

References 14 publications

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“…15 With age, the continuity between these two structures diminishes and the retrocalcaneal bursa adjacent to the tendon Achilles insertion become calcified, altering the actual zone of tendon attachment. 6,15 These age-related changes to the Achilles tendon, combined with diminished bone density, explain an increased incidence of calcaneal tuberosity avulsion fractures in the elderly, particularly females. • Diabetes Mellitus Table 1 Various mechanisms of avulsion fracture injury associated with possible etiologies as described in the literature.…”

Section: Anatomymentioning

confidence: 99%

“…In this position the force from a loaded Achilles tendon is transmitted to the calcaneal tuberosity, and to the plantar fascia by a series of highly oriented trabeculae. 6,16 When the gastrocnemius-soleus complex contracts which occurs after a low impact fall, sudden forced dorsiflexion occurs, pulling the tendon Achilles and causing avulsion of a fragment of bone. The size of the avulsed fragment will depend on the position of the foot during impact.…”

Section: Pathogenesismentioning

confidence: 99%

“…5 Avulsion fractures of the calcaneal tuberosity comprise only 1.3% to 2.7% of calcaneal fractures. 5,6 The peak incidence is in females in their seventh decade as a consequence of diminished bone mineral density. 1,7,8,9 Most calcaneal fractures are closed injuries that are treated non-operatively, or if treated operatively, surgery is delayed to allow the soft tissues to recover and lower the incidence of incisional complications.…”

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confidence: 99%

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Avulsion Fracture of the Calcaneal Tuberosity: A soft tissue complication from delayed treatment

MBChB¹,

MBChB²,

Golele³

et al. 2010

FAOJ

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Section: Anatomymentioning

confidence: 99%

Section: Pathogenesismentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

Avulsion Fracture of the Calcaneal Tuberosity: A soft tissue complication from delayed treatment

MBChB¹,

MBChB²,

Golele³

et al. 2010

FAOJ

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“…Only a small percentage of calcaneus fractures occur on the calcaneal tuberosity [1][2][3]. Beavis et al classified these fractures into three types.…”

Section: Introductionmentioning

confidence: 99%

“…Beavis et al classified these fractures into three types. A type I fracture is a true avulsion type, called a "sleeve" fracture; a type II fracture is an "open beak" type; and a type III fracture is a type of infrabursal avulsion of the middle third of the tuberosity [3]. Recently, Lee et al modified the classification to include four types [4].…”

Section: Introductionmentioning

confidence: 99%

A Novel Technique for Calcaneal Avulsion Fracture: A Case Report

Shimozaki¹,

Inatani²,

Numata³

et al. 2016

J Trauma Treat

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Avulsion fractures of the calcaneal tuberosity constitute only a small percentage of calcaneal fractures. Avulsion fractures often occur in elderly women with osteoporosis. Various surgical methods are used in the treatment of this type of fracture. These include tension band wiring, suture anchor fixation, lag screw fixation, and TightRope® technique. In order to manage these fractures effectively, it is important to avoid skin necrosis and to ensure strong fixation that can resist the pull of triceps surae. We performed a novel technique using Achilles SpeedBridge™ and a cannulated lag screw. This technique allows for strong and easy fixation. A 57-year-old man presented to our department with a left ankle injury caused by slipping on a rocky area next to the sea. We diagnosed a type I calcaneal avulsion fracture, and planned surgical fixation. Surgery was performed 3 days after the injury. Postoperatively, the patient used a brace to maintain the ankle in the natural position for three weeks. Full weight bearing was started with Achilles boots after the brace was removed. His ankle range of motion was 30° plantar flexion and 60° dorsiflexion. He could perform all movements without any issues and without requiring support. His preoperative American Orhopaedic Foot and Ankle Society score was 52/100, and after 3 months this had increased to 100/100. We believe that this technique is highly effective for the treatment of type I calcaneal avulsion fractures.

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Biomechanical consequences of adding plantar fascia release to metatarsal osteotomies: Changes in forefoot plantar pressures

Aydogan

Roush

Moore

et al. 2016

Journal Orthopaedic Research

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Destruction of the normal metatarsal arch by a long metatarsal is often a cause for metatarsalgia. When surgery is warranted, distal oblique or proximal dorsiflexion osteotomies of the long metatarsal bones are commonly used. The plantar fascia has anatomical connection to all metatarsal heads. There is controversial scientific evidence on the effect of plantar fascia release on forefoot biomechanics. In this cadaveric biomechanical study, we hypothesized that plantar fascia release would augment the plantar metatarsal pressure decreasing effects of two common second metatarsal osteotomy techniques. Six matched pairs of foot and ankle specimens were mounted on a pressure mat loading platform. Two randomly assigned surgery groups, which had received either distal oblique or proximal dorsiflexion osteotomy of the second metatarsal, were evaluated before and after plantar fasciectomy. Specimens were loaded up to a ground reaction force of 400 N at varying Achilles tendon forces. Average pressures, peak pressures, and contact areas were analyzed. Supporting our hypothesis, average pressures under the second metatarsal during 600 N Achilles load were decreased by plantar fascia release following proximal osteotomy (p<.05). However contrary to our hypothesis, peak pressures under the second metatarsal were significantly increased by plantar fascia release following modified distal osteotomy, under multiple Achilles loading conditions (p<.05).

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Avulsion Fracture of the Calcaneal Tuberosity: A Case Report and Literature Review

Cited by 98 publications

References 14 publications

Avulsion Fracture of the Calcaneal Tuberosity: A soft tissue complication from delayed treatment

Avulsion Fracture of the Calcaneal Tuberosity: A soft tissue complication from delayed treatment

A Novel Technique for Calcaneal Avulsion Fracture: A Case Report

Biomechanical consequences of adding plantar fascia release to metatarsal osteotomies: Changes in forefoot plantar pressures

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