MANAGEMENT OF DISPLACED CALCANEUS FRACTURE
Mohamed Yousef Mohamed Yousef;
Abstract
The calcaneus is the largest of the tarsal bones. It is irregularly cuboidal and designed to withstand the daily stresses of weight bearing. The calcaneus have architecture much like an egg; hard on the outside and very soft in the center. And just like an egg, the calcaneus is very susceptible the crush injuries.
Its anterior half supports the talus. The later, in turn, carries the whole body load through the tibia. The calcaneus serves a dual purpose: it provides an elastic, firm support for the weight of the body and also functions as a spring board for locomotion.
Axial loading is responsible for the majority of intra-articular calcaneal fractures. Usually, the axial load results from a fall from a height. Any fall – even a short one – may result in fracture as the talus is driven downward into the calcaneus. Twisting forces and avulsive forces cause many of the extra-articular fractures.
Many attempts have been made to classify fractures of the calcaneus, however, no single classification system has been completely satisfactory. For clinical use, the Essex-Loperesti classification is the simplest, but it provides no framework for determining surgical strategies or determining the long term outcome divided calcaneal fractures into two main categories: extra-articular and intra-articular fracture. The classification of Sanders et al. has the advantage of enabling outcome prognostication and that of Zwipp et at. offers the best way to describe the typically complex pattern of calcaneal fractures.
Clinical and radiological examinations are essential for any patient with calcaneal fractures to exclude fracture of the spine or similar injury to the other foot. For any patient who complain of hind foot pain after an injury, the basic radiographic examination should include all the standard and oblique views to diagnose the location and degree of severity of calcaneal fractures. The CT scanning which can demonstrate the anatomy of the subtalar joint in several planes with minimal positioning of the patient and give excellent visualization of the articular facets, combined with conventional lateral and axial views defines precisely the making. MRI allowed excellent detailed visualization of the calcaneal fat bad and surrounding structures.
The appropriate care of calcaneal fracture continues to be an unresolved dilemma and the history of treatment is characterized by periods of enthusiasm for surgical intervention followed closely by periods of advocacy of closed treatment methods.
While there is little disagreement surrounds the treatment of extra-articular fractures of the calcaneus with good results in the majority of cases, significant controversy remains over the results of non-operative versus operative treatment for the intra-articular fractures of the calcaneus.
Its anterior half supports the talus. The later, in turn, carries the whole body load through the tibia. The calcaneus serves a dual purpose: it provides an elastic, firm support for the weight of the body and also functions as a spring board for locomotion.
Axial loading is responsible for the majority of intra-articular calcaneal fractures. Usually, the axial load results from a fall from a height. Any fall – even a short one – may result in fracture as the talus is driven downward into the calcaneus. Twisting forces and avulsive forces cause many of the extra-articular fractures.
Many attempts have been made to classify fractures of the calcaneus, however, no single classification system has been completely satisfactory. For clinical use, the Essex-Loperesti classification is the simplest, but it provides no framework for determining surgical strategies or determining the long term outcome divided calcaneal fractures into two main categories: extra-articular and intra-articular fracture. The classification of Sanders et al. has the advantage of enabling outcome prognostication and that of Zwipp et at. offers the best way to describe the typically complex pattern of calcaneal fractures.
Clinical and radiological examinations are essential for any patient with calcaneal fractures to exclude fracture of the spine or similar injury to the other foot. For any patient who complain of hind foot pain after an injury, the basic radiographic examination should include all the standard and oblique views to diagnose the location and degree of severity of calcaneal fractures. The CT scanning which can demonstrate the anatomy of the subtalar joint in several planes with minimal positioning of the patient and give excellent visualization of the articular facets, combined with conventional lateral and axial views defines precisely the making. MRI allowed excellent detailed visualization of the calcaneal fat bad and surrounding structures.
The appropriate care of calcaneal fracture continues to be an unresolved dilemma and the history of treatment is characterized by periods of enthusiasm for surgical intervention followed closely by periods of advocacy of closed treatment methods.
While there is little disagreement surrounds the treatment of extra-articular fractures of the calcaneus with good results in the majority of cases, significant controversy remains over the results of non-operative versus operative treatment for the intra-articular fractures of the calcaneus.
Other data
| Title | MANAGEMENT OF DISPLACED CALCANEUS FRACTURE | Other Titles | كیفیة معالجة الكسر العقبي المتباعد | Authors | Mohamed Yousef Mohamed Yousef | Issue Date | 2015 |
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