Pathoanatomy of Intra-Articular Fractures of the Calcaneus*

Miric, Alexander; Patterson, Brendan M.

doi:10.2106/00004623-199802000-00007

Cited by 40 publications

(28 citation statements)

References 13 publications

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“…In a prior review of CT scans performed on joint depression calcaneus fractures, the primary fracture line was noted to extend into the anterior process in 85 of 116 fractures. 19 Sixty-seven primary fracture lines entered the calcaneocuboid joint, 10 involved the middle facet, and 31 involved the anterior facet. 19 Wagner and colleagues studied the contact characteristics of the subtalar joint and assessed load distribution between the anterior and posterior facets.…”

Section: Discussionmentioning

confidence: 99%

“…19 Sixty-seven primary fracture lines entered the calcaneocuboid joint, 10 involved the middle facet, and 31 involved the anterior facet. 19 Wagner and colleagues studied the contact characteristics of the subtalar joint and assessed load distribution between the anterior and posterior facets. 25 They found that under an axial load, the contact pressures in the anterior facet, the middle facet, or both, were significantly greater than those in the posterior facet.…”

Section: Discussionmentioning

confidence: 99%

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Prognostic Value of Computed Tomography Classification Systems for Intra-articular Calcaneus Fractures

et al. 2014

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Prognostic Value of Computed Tomography Classification Systems for Intra-articular Calcaneus Fractures

et al. 2014

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“…Fractures of the calcaneus that account for 60% of the tarsal injuries are therefore of great clinical impact to the patients affected, and their treatment requires major efforts of the orthopedic trauma surgeon. [28][29][30][31][32][33] There is consensus that biomechanic factors, especially the energy of the trauma leading to the injury and the position of the foot at that time, are major components in the pathogenesis of calcaneal fractures, and this is clinically confirmed by the observation that most calcaneal fractures occur in physically active males like industrial workers. 31 However, that a destruction of the microarchitecture can constitute a risk factor to fracture has been recently suggested for patients with calcaneal bone cysts 34 and also by a report of two cases with insufficiency fracture of the body of the calcaneus in elderly women.…”

Section: Discussionmentioning

confidence: 99%

Bone microarchitecture of the calcaneus and its changes in aging: A histomorphometric analysis of 60 human specimens

Rupprecht¹,

Pogoda²,

Mumme³

et al. 2006

J. Orthop. Res.

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Bone structure and quality are an important parameter in the propensity of bone to fracture. Although the calcaneus is used as diagnostic reference site for osteoporosis by ultrasound, its structure has never been analyzed in detail. The purpose of this study was therefore to histomorphometrically analyze the trabecular microarchitecture of the calcaneus, and to determine whether the calcaneal bone structure is changing with age. Sixty complete human calcanei were harvested from thirty age-and gender-matched patients at autopsy. Each of the three different age groups (group I: 20 to 40, group II: 41 to 60, group III: 61 to 80 years of age) was represented by 20 specimens. The specimens were subjected to radiographic, mCT, and histologic analysis. Bone structure and bone mass of the calcaneus were quantified for three different regions of interest: the anterior ROI, the superior ROI (the subtalar region under the posterior facet), and the posterior ROI. An iliac crest biopsy was obtained from all patients to exclude any metabolic bone disease. Histomorphometric analysis revealed significant differences in bone volume within the calcaneus with highest values in the superior ROI: age group I: 31.3% (27.8-34.8%); II: 25.5% (22.1-28.9%); III: 18.9% (16.6-21.2%) and lowest bone volumes in the anterior ROI; age group I: 6.2% (4.8-7.6%); II: 3.6% (2.1-5.1%); III: 3.9% (2.9-4.9%). There was a significant age-related decrease in bone volume (BV/TV) in aging. Interestingly, this bone loss was most prominent in the superior ROI, with a 39% decrease in BV/TV between age group I and III ( p < 0.001). Qualitative and structural analysis of trabecular number, thickness, and spacing demonstrated that the bone loss in the thalamic portion of the calcaneus was due to the transition of plate-like trabecular elements into a rod-like structure. In conclusion, our study demonstrated that the calcaneus displayed age-related changes in its microarchitecture that are known to reduce the biomechanical stability of trabecular bone, and that the age-related bone loss was most prominent in the region adjacent to the posterior facet (superior ROI). These results suggest that bone mass and structure are risk factors in respect to the occurrence and severity of calcaneal fractures, and indicate that calcaneal fractures are at least in part osteoporotic fractures. ß

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“…Der Einfluss des Pitchfaktors war somit nicht relevant und hatte auf die exakte Einschät-zung des Frakturverlaufs keinen erkennbaren Effekt. [2,22]. Extraartikuläre Frakturen (A1-Frakturen) heilen in der Regel schnell und zeigen nur eine geringe Folgemorbidität [6].…”

Section: Introductionunclassified

“…Wuelker et al fanden bei experimentell erzeugten Frakturen eine Ausdehnung in dieses Gelenk in 44 % der Fälle [16]. In nicht selektionierten Patientenkollektiven liegen die Häufigkeiten bei 58 -80 % [2,5,16,22]. Insbesondere bei höhergradigen Joint-depression-Frakturen ist das kalkaneo-kuboidale Gelenk in aller Regel mitbetroffen.…”

Section: Introductionunclassified