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Normughni Fikirudin
INTRODUCTION
• Joseph-Francois Malgaigne described
intraarticular fracture patterns of the
calcaneus in 1843
• Most commonly fractured tarsal bone
(60%)
• Occurs more commonly in active
working males (peak age 20 to 29)
• Most common mechanism is a fall from
height or MVC
• 25- 50% of have associated injuries.
Anatomy
• Calcaneus is the largest tarsal bone
• Enveloped in a shell of thin cortical bone
• On the anterior superior aspect of medial
surface the large sustentaculum tali is
the strongest part of the bone is the key to
reduction and stabilization In fracture of this
bone
• Attached to it is the strong calcaneonavicular
ligament& ant fibers of deltoid ligament
• Passed under it is the FHL & FDL
6 Surfaces
• The superior surface: articulates with the talus
• The distal surface articulates with the cuboid
• The medial surface called the sustentaculum tali
supports the head of the talus.
• The posterior surface provide attachment place for
the Achilles tendon
• The roughed inferior surface forms the major
weight bearing area of the calcaneus
• High fluid content helps the calcaneus to function
as a hydrodynamic shock absorber during impact
(Grimm and Williams, 1997).
Sustentaculum tali
• Supports middle facet of talus
Sustentaculum
• Fulcrum for FHL tendon tali
2. Detailed NV exam
3. Associated injuries?
4. Serial exams in the first hours after presentation to monitor for
compartment syndrome Approximately 10% of calcaneal
fractures develop compartment
syndromes of the foot-Myerson
1993
Radiographic Evaluation
• Plain radiographs (XR)
• AP/Lateral/Oblique views of the foot
• Mortise view of ankle to r/o associated ankle pathology
• Axial (Harris) view
• Anatomic reduction
• Correction of deformity-
• Restore length for foot alignment
• Restore height for ankle function