Displaced Intra-articular Calcaneal Fractures: Classification and Treatment

Abstract

The calcaneus is the most commonly fractured tarsal bone. Displaced intraarticular calcaneal fractures are usually caused by a fall from height with one or both heels directly hitting the ground. Displaced intra-articular calcaneal fractures are complex and highly disabling injuries. There is ongoing debate regarding the optimal treatment for each type of displaced intra-articular calcaneal fracture. This review aims to summarize the classification of, various treatment options for, prevention of perioperative complications in, and management algorithms for displaced intra-articular calcaneal fractures. [Orthopedics. 2017; 40(6):e921-e929.].

Comparison of Surgical Techniques for the Treatment of Intraarticular Calcaneal Fractures

“…Firstly, because of its retrospective nature, some bias may be of concern, but as we showed statistically, there was no relation between the comminution of the fracture and surgical method chosen. Secondly, we did not evaluate the medical conditions such as diabetes mellitus and smoking, which were shown to be related with poorer outcomes (40), because of the possible imperfection of medical records. Thirdly, a relatively short follow-up period may mask some late stage complications such as arthritis of subtalar joint.…”

Imaging Considerations in Musculoskeletal Trauma

“…Although calcaneal fractures account for only 1% to 4% of all fractures, the calcaneus is the most frequently fractured tarsal bone. 7,10,11 More importantly, over 75% of patients with a calcaneus fracture will have additional injury; therefore, it is essential that these patients are subjected to a thorough assessment, including a physical examination and imaging. 7 More than 90% of calcaneus fractures result from motor vehicle crashes (MVCs) or falls from heights.…”

Intra-articular Calcaneus Fractures: Current Concepts Review

“…As a result, these fractures may lead to skin tenting of the posterior heel with risk of subsequent pressure necrosis, and thus can require urgent operative management. 16,50,60 Serial physical examinations should be performed in patients with tongue-type fractures to identify blanching and other signs of skin breakdown over the fracture site. 50…”