Calcaneal fracture: Difference between revisions
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{{Infobox medical condition | |||
| name = Calcaneal fracture | |||
| image = [[File:CalFrac.png|left|thumb|Calcaneal fracture]] | |||
| caption = X-ray of a calcaneal fracture | |||
| field = [[Orthopedic surgery]] | |||
| synonyms = Heel bone fracture | |||
| symptoms = [[Heel pain]], [[swelling]], [[bruising]], inability to bear weight | |||
| complications = [[Arthritis]], [[chronic pain]], [[deformity]] | |||
| onset = Sudden, due to trauma | |||
| duration = Varies, often weeks to months | |||
| causes = [[Trauma]], such as a fall from height or motor vehicle accident | |||
| risks = [[Osteoporosis]], high-impact activities | |||
| diagnosis = [[Physical examination]], [[X-ray]], [[CT scan]] | |||
| differential = [[Ankle fracture]], [[Plantar fasciitis]], [[Achilles tendon rupture]] | |||
| prevention = Use of protective footwear, avoiding high-risk activities | |||
| treatment = [[Rest]], [[ice]], [[compression]], [[elevation]], [[surgery]] | |||
| medication = [[Pain management]] with [[NSAIDs]] or [[opioids]] | |||
| prognosis = Varies, depends on severity and treatment | |||
| frequency = Common in high-impact trauma cases | |||
}} | |||
== Calcaneal Fracture == | == Calcaneal Fracture == | ||
A '''calcaneal fracture''' is a break in the [[calcaneus]], also known as the heel bone. This type of fracture is often caused by high-energy trauma such as a fall from a height or a motor vehicle accident. Calcaneal fractures can be quite debilitating due to the critical role the calcaneus plays in weight-bearing and walking. | A '''calcaneal fracture''' is a break in the [[calcaneus]], also known as the heel bone. This type of fracture is often caused by high-energy trauma such as a fall from a height or a motor vehicle accident. Calcaneal fractures can be quite debilitating due to the critical role the calcaneus plays in weight-bearing and walking. | ||
[[File:CalFrac.png|Calcaneal fracture|left|thumb]] | |||
[[File:CalFrac.png|Calcaneal fracture|thumb | |||
== Anatomy == | == Anatomy == | ||
The [[calcaneus]] is the largest of the [[tarsal bones]] in the foot and forms the heel. It is crucial for normal foot function, providing support and stability. The calcaneus articulates with the [[talus]] above and the [[cuboid bone]] in front, forming part of the [[subtalar joint]] and the [[calcaneocuboid joint]]. | The [[calcaneus]] is the largest of the [[tarsal bones]] in the foot and forms the heel. It is crucial for normal foot function, providing support and stability. The calcaneus articulates with the [[talus]] above and the [[cuboid bone]] in front, forming part of the [[subtalar joint]] and the [[calcaneocuboid joint]]. | ||
== Types of Calcaneal Fractures == | == Types of Calcaneal Fractures == | ||
Calcaneal fractures can be classified into two main types: | Calcaneal fractures can be classified into two main types: | ||
* '''Intra-articular fractures''': These involve the [[subtalar joint]] and are more common, accounting for about 75% of all calcaneal fractures. They are often more severe and can lead to long-term complications such as [[arthritis]]. | * '''Intra-articular fractures''': These involve the [[subtalar joint]] and are more common, accounting for about 75% of all calcaneal fractures. They are often more severe and can lead to long-term complications such as [[arthritis]]. | ||
* '''Extra-articular fractures''': These do not involve the subtalar joint and are less common. They may occur in the [[calcaneal tuberosity]], the [[sustentaculum tali]], or the anterior process of the calcaneus. | * '''Extra-articular fractures''': These do not involve the subtalar joint and are less common. They may occur in the [[calcaneal tuberosity]], the [[sustentaculum tali]], or the anterior process of the calcaneus. | ||
== Diagnosis == | == Diagnosis == | ||
Diagnosis of a calcaneal fracture typically involves a combination of physical examination and imaging studies. | Diagnosis of a calcaneal fracture typically involves a combination of physical examination and imaging studies. | ||
[[File:CalcanealfractCT.png|CT scan of calcaneal fracture|left|thumb]] | |||
[[File:CalcanealfractCT.png|CT scan of calcaneal fracture|thumb | |||
=== Imaging === | === Imaging === | ||
* '''X-rays''': Standard X-rays are used to assess the fracture and include lateral, axial, and oblique views. | * '''X-rays''': Standard X-rays are used to assess the fracture and include lateral, axial, and oblique views. | ||
* '''CT scans''': These provide a more detailed view of the fracture pattern and are particularly useful for intra-articular fractures. | * '''CT scans''': These provide a more detailed view of the fracture pattern and are particularly useful for intra-articular fractures. | ||
[[File:Bohler's_angle_(raster).jpg|Böhler's angle measurement|left|thumb]] | |||
[[File:Bohler's_angle_(raster).jpg|Böhler's angle measurement|thumb | |||
=== Böhler's Angle === | === Böhler's Angle === | ||
Böhler's angle is an important measurement used in the assessment of calcaneal fractures. It is formed by the intersection of two lines: one from the highest point of the anterior process to the highest point of the posterior articular facet, and the other from the highest point of the posterior articular facet to the highest point of the calcaneal tuberosity. A normal Böhler's angle ranges from 20 to 40 degrees. A decrease in this angle is indicative of a fracture. | Böhler's angle is an important measurement used in the assessment of calcaneal fractures. It is formed by the intersection of two lines: one from the highest point of the anterior process to the highest point of the posterior articular facet, and the other from the highest point of the posterior articular facet to the highest point of the calcaneal tuberosity. A normal Böhler's angle ranges from 20 to 40 degrees. A decrease in this angle is indicative of a fracture. | ||
[[File:Gissane.jpg|Gissane's angle|left|thumb]] | |||
[[File:Gissane.jpg|Gissane's angle|thumb | |||
=== Gissane's Angle === | === Gissane's Angle === | ||
Gissane's angle, also known as the "critical angle," is another important measurement. It is formed by the downward and upward slopes of the calcaneal superior surface. A normal Gissane's angle is between 120 and 145 degrees. | Gissane's angle, also known as the "critical angle," is another important measurement. It is formed by the downward and upward slopes of the calcaneal superior surface. A normal Gissane's angle is between 120 and 145 degrees. | ||
== Treatment == | == Treatment == | ||
Treatment of calcaneal fractures depends on the type and severity of the fracture. Options include: | Treatment of calcaneal fractures depends on the type and severity of the fracture. Options include: | ||
* '''Conservative treatment''': This may involve rest, ice, compression, and elevation (RICE), along with immobilization in a cast or splint. | * '''Conservative treatment''': This may involve rest, ice, compression, and elevation (RICE), along with immobilization in a cast or splint. | ||
* '''Surgical treatment''': Surgery may be required for displaced intra-articular fractures. Techniques include open reduction and internal fixation (ORIF). | * '''Surgical treatment''': Surgery may be required for displaced intra-articular fractures. Techniques include open reduction and internal fixation (ORIF). | ||
== Rehabilitation == | == Rehabilitation == | ||
Rehabilitation is crucial for recovery and involves physical therapy to restore range of motion, strength, and function. Weight-bearing is typically restricted until the fracture has healed sufficiently. | Rehabilitation is crucial for recovery and involves physical therapy to restore range of motion, strength, and function. Weight-bearing is typically restricted until the fracture has healed sufficiently. | ||
[[File:Calcaneal_fracture_neutral_lposition.jpg|Calcaneal fracture in neutral position|left|thumb]] | |||
[[File:Calcaneal_fracture_neutral_lposition.jpg|Calcaneal fracture in neutral position|thumb | |||
== Prognosis == | == Prognosis == | ||
The prognosis for calcaneal fractures varies. Factors influencing recovery include the severity of the fracture, the quality of the reduction, and the presence of complications such as [[post-traumatic arthritis]]. | The prognosis for calcaneal fractures varies. Factors influencing recovery include the severity of the fracture, the quality of the reduction, and the presence of complications such as [[post-traumatic arthritis]]. | ||
== See also == | |||
== | |||
* [[Fracture]] | * [[Fracture]] | ||
* [[Subtalar joint]] | * [[Subtalar joint]] | ||
* [[Orthopedic surgery]] | * [[Orthopedic surgery]] | ||
[[Category:Orthopedic injuries]] | [[Category:Orthopedic injuries]] | ||
[[Category:Foot and ankle]] | [[Category:Foot and ankle]] | ||
Latest revision as of 21:42, 4 April 2025
Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
Founder, WikiMD Wellnesspedia &
W8MD medical weight loss NYC and sleep center NYC
| Calcaneal fracture | |
|---|---|
 | |
| Synonyms | Heel bone fracture |
| Pronounce | N/A |
| Specialty | N/A |
| Symptoms | Heel pain, swelling, bruising, inability to bear weight |
| Complications | Arthritis, chronic pain, deformity |
| Onset | Sudden, due to trauma |
| Duration | Varies, often weeks to months |
| Types | N/A |
| Causes | Trauma, such as a fall from height or motor vehicle accident |
| Risks | Osteoporosis, high-impact activities |
| Diagnosis | Physical examination, X-ray, CT scan |
| Differential diagnosis | Ankle fracture, Plantar fasciitis, Achilles tendon rupture |
| Prevention | Use of protective footwear, avoiding high-risk activities |
| Treatment | Rest, ice, compression, elevation, surgery |
| Medication | Pain management with NSAIDs or opioids |
| Prognosis | Varies, depends on severity and treatment |
| Frequency | Common in high-impact trauma cases |
| Deaths | N/A |
Calcaneal Fracture[edit]
A calcaneal fracture is a break in the calcaneus, also known as the heel bone. This type of fracture is often caused by high-energy trauma such as a fall from a height or a motor vehicle accident. Calcaneal fractures can be quite debilitating due to the critical role the calcaneus plays in weight-bearing and walking.
Anatomy[edit]
The calcaneus is the largest of the tarsal bones in the foot and forms the heel. It is crucial for normal foot function, providing support and stability. The calcaneus articulates with the talus above and the cuboid bone in front, forming part of the subtalar joint and the calcaneocuboid joint.
Types of Calcaneal Fractures[edit]
Calcaneal fractures can be classified into two main types:
- Intra-articular fractures: These involve the subtalar joint and are more common, accounting for about 75% of all calcaneal fractures. They are often more severe and can lead to long-term complications such as arthritis.
- Extra-articular fractures: These do not involve the subtalar joint and are less common. They may occur in the calcaneal tuberosity, the sustentaculum tali, or the anterior process of the calcaneus.
Diagnosis[edit]
Diagnosis of a calcaneal fracture typically involves a combination of physical examination and imaging studies.
Imaging[edit]
- X-rays: Standard X-rays are used to assess the fracture and include lateral, axial, and oblique views.
- CT scans: These provide a more detailed view of the fracture pattern and are particularly useful for intra-articular fractures.
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Böhler's Angle[edit]
Böhler's angle is an important measurement used in the assessment of calcaneal fractures. It is formed by the intersection of two lines: one from the highest point of the anterior process to the highest point of the posterior articular facet, and the other from the highest point of the posterior articular facet to the highest point of the calcaneal tuberosity. A normal Böhler's angle ranges from 20 to 40 degrees. A decrease in this angle is indicative of a fracture.
Gissane's Angle[edit]
Gissane's angle, also known as the "critical angle," is another important measurement. It is formed by the downward and upward slopes of the calcaneal superior surface. A normal Gissane's angle is between 120 and 145 degrees.
Treatment[edit]
Treatment of calcaneal fractures depends on the type and severity of the fracture. Options include:
- Conservative treatment: This may involve rest, ice, compression, and elevation (RICE), along with immobilization in a cast or splint.
- Surgical treatment: Surgery may be required for displaced intra-articular fractures. Techniques include open reduction and internal fixation (ORIF).
Rehabilitation[edit]
Rehabilitation is crucial for recovery and involves physical therapy to restore range of motion, strength, and function. Weight-bearing is typically restricted until the fracture has healed sufficiently.
Prognosis[edit]
The prognosis for calcaneal fractures varies. Factors influencing recovery include the severity of the fracture, the quality of the reduction, and the presence of complications such as post-traumatic arthritis.
