tongue type calcaneus fracture radiology
Calcaneus Fractures: A Possible Musculoskeletal Emergency. ACS Level I trauma center. Cao Y, Xu X, Guo Y, Cui Z, Zhao Y, Gao S, Tian Y, Lv Y, Zhou F. Front Surg. Banerjee R, Chao JC, Taylor R, Siddiqui A. J Am Acad Orthop Surg. J Orthop Trauma 28(10):551563, Lu B, Liu P, Wang Y, Yuan JB, Tang XM, Wei D et al (2015) Minimally invasive manipulative reduction with poking k-wire fixation in the treatment of various types of calcaneal fractures. Executive Editors. Occasionally, it is completely extraarticular but deserves the same operative treatment and reduction. Clin Orthop Relat Res 30:6466, Article These injuries require urgent reduction and fixation in order to minimize soft tissue compromise from the pressure of the displaced tuberosity fragment on the posterior heel skin. Tongue-type fractures are unusual calcaneal fractures that produce an unique and relatively uncommon injury pattern to the bone and soft tissues, due to the separation of the calcaneal tuberosity into superior and inferior fragments. Clipboard, Search History, and several other advanced features are temporarily unavailable. Types IV and V(60%) involve the subtalar joint. Emerg Radiol. De Boer AS, Van Lieshout EMM, Van 't Land F, Misselyn D, Schepers T, Den Hartog D, Verhofstad MHJ. 2008 Aug;22(7):439-45. doi: 10.1097/BOT.0b013e31817ace7e. Emerg Radiol 26, 6774 (2019). Foot Ankle Surg 22(1):18, Keck School of Medicine, University of Southern California, Los Angeles, USA, Eric A. Twenty-nine fractures (21%) had some degree of posterior skin compromise at presentation, including 12 with threatened skin, 10 with partial thickness breakdown, and 7 with full thickness breakdown. Unable to load your collection due to an error, Unable to load your delegates due to an error. PubMed Tongue-type calcaneal fractures represent 14% to 20% of all calcaneus fractures. Patients/participants: Fifty-six displaced Sanders 2B and 2C tongue-type calcaneus fractures identified from an initial cohort of 1118 . Disclaimer, National Library of Medicine Overall tongue type calcaneal fractures tend to have a more favourable prognosis when compared to articular depression patterns and perhaps not surprisingly treating these injuries with percutaneous techniques also offers advantage. Ann Plast Surg 52(4):380384, Khai Luen K, Wan Sulaiman WA (2017) Functional outcomes after heel pad reconstruction: a review of 7 cases. These should be treated with immediate reduction, plantarflexion splinting, and close monitoring. Calcaneal fractures account for 60% of all tarsal bone fractures. During this procedure, the surgeon stabilizes the bone with hardware to allow the bone to heal properly. MeSH Epub 2018 Jul 30. 1975 Nov;57(4):413-21 Calcaneal fractures have characteristic appearances based on the mechanism of injury and are divided into two major groups, intraarticular and extraarticular. Description of Extreme tongue-type (beak) fracture of the calcaneus body. J Foot Ankle Surg. Type V fractures are comminuted fractures with a centrally depressed fragment. eCollection 2022. The site is secure. 2020 Jul 28;5(3):2473011420927334. doi: 10.1177/2473011420927334. Mehta S, Mirza AJ, Dunbar RP, Barei DP, Benirschke SK. Bookshelf Displacement of the sustentacular fragment in intra-articular calcaneal fractures. doi: 10.1016/j.ajem.2007.04.033. Clipboard, Search History, and several other advanced features are temporarily unavailable. Design: Retrospective cohort. An The .gov means its official. The Essex-Lopresti reduction for calcaneal fractures revisited. A recent retrospective cohort study by Quirine showed a lower incidence of wound problems and deep infection when . Berberian W, Sood A, Karanfilian B, Najarian R, Lin S, Liporace F. J Bone Joint Surg Am. FOIA 2022 Mar;23(3):196. doi: 10.3892/etm.2022.11119. HHS Vulnerability Disclosure, Help Foot Ankle 6(4):184193, Wong-Chung J, O'Longain D, Lynch-Wong M, Julian H (2016) Irreducible tongue-type calcaneal fracture due to interposition of flexor hallucis longus. Keywords: Open all credits. Main outcome measurements: Intra-articular tongue-type fractures of the calcaneus: anatomy, injury patterns, and an approach to management. Fig. Cao Y, Xu X, Guo Y, Cui Z, Zhao Y, Gao S, Tian Y, Lv Y, Zhou F. Front Surg. Patient demographics, comorbidities, injury mechanism, fracture displacement, and time to presentation were evaluated. J Orthop Trauma 20(9):618622, Tornetta P 3rd. Unable to load your collection due to an error, Unable to load your delegates due to an error. Accessibility The purpose of this study was to determine the incidence of posterior skin involvement in tongue-type calcaneus fractures and to determine the patient and fracture characteristics that lead to high-risk situations. 1998 Sep-Oct;12(7):469-73. doi: 10.1097/00005131-199809000-00007. Recognition of the imaging findings, accurate interpretation, and timely communication may prevent devastating clinical outcomes including soft tissue coverage procedures and amputation. Accessibility Orthopedics. Calcaneal fracture; Computed tomography; Musculoskeletal; Radiography; Tongue-type fracture; Trauma. Type I (20%) the fracture line may be through the tuberosity, the sustentaculum tali, or the anterior process of the calcaneus. Disclaimer, National Library of Medicine et al. Foot 19(4):197200, Article Tongue-type fractures are unusual calcaneal fractures in which the displacement of a bony fragment has the potential to tent the skin of the posterior heel. In the axial plane, 98% of tongue pieces were in a position of adduction (64%) or neutral (34%), with an average angulation into adduction of 15.0 degrees. Before Results: J Orthop Trauma. Open wounds occur with calcaneus fracture from direct application of force and from tearing along the medial side of the fracture as the tuberosity displaces laterally. Semin Musculoskelet Radiol 14(3):307322, Pierre-Jerome C, Moncayo V, Terk MR (2010) MRI of the Achilles tendon: a comprehensive review of the anatomy, biomechanics, and imaging of overuse tendinopathies. 2022 Jan 21;17(1):39. doi: 10.1186/s13018-022-02930-y. Anyone you share the following link with will be able to read this content: Sorry, a shareable link is not currently available for this article. Careers. eCollection 2022 Nov-Dec. Cursaru A, Creu B, erban B, Iordache S, Popa M, Smarandache CG, Orban C, Crstoiu C. Exp Ther Med. The .gov means its official. Soft tissue complications and timing of surgery in patients with a tongue-type displaced intra-articular calcaneal fracture: An international retrospective cohort study. Please enable it to take advantage of the complete set of features! J Orthop Trauma. Clipboard, Search History, and several other advanced features are temporarily unavailable. Intra-articular tongue-type fractures may develop skin breakdown and often require urgent surgical reduction and fixation. Setting: ACS Level I trauma center. a Lateral radiograph shows a comminuted calcaneal fracture with a tongue-type component (arrow). and osteoarticular radiology . Patients/participants: Bookshelf Google Scholar, Walters JL, Gangopadhyay P, Malay DS (2014) Association of calcaneal and spinal fractures. and transmitted securely. The .gov means its official. Patients with posterior skin compromise were less likely to have a fall mechanism (P = 0.001), had significantly greater fracture displacement (P = 0.007), were more likely to smoke (P = 0.039), and were more frequently referred on a delayed basis (P = 0.007). J Bone Joint Surg Br. Setting: It is primarily based on radiographic findings and distinguishes intraarticular fracture patterns into two types (depending on the exit point of the secondary fracture line): "tongue type" and "joint depression" fractures [ 2] [ Figure 1 ]. Foot Ankle Int 30(3):229238, Johnson PT, Fayad LM, Fishman EK (2006) Sixteen-slice CT with volumetric analysis of foot fractures. Clin Orthop Relat Res 290:316, Qiang M, Chen Y, Zhang K, Li H, Dai H (2014) Measurement of three-dimensional morphological characteristics of the calcaneus using CT image post-processing. Management of calcaneal tuberosity fractures. 2019 Feb;26(1):67-74. doi: 10.1007/s10140-018-1629-4. Femino JE, Vaseenon T, Levin DA, Yian EH. All tongue-type calcaneus fractures treated at 1 institution between 2002 and 2007 were identified from a trauma registry. Google Scholar, Sanders R, Vaupel ZM, Erdogan M, Downes K (2014) Operative treatment of displaced intraarticular calcaneal fractures: long-term (10-20 years) results in 108 fractures using a prognostic CT classification. Tongue-type calcaneus fractures are longitudinal fractures that exit the calcaneal tuberosity posteriorly and involve a portion of the articular surface. They are often superiorly displaced because of the insertion of the Achilles tendon and pull of the gastroc-soleus complex. 8600 Rockville Pike The site is secure. This article reviews the anatomy of the calcaneus, as well as the clinical presentation and imaging findings of intra-articular tongue-type fractures. Those injuries that were associated with posterior, secondary soft tissue breakdown were identified and compared to those without breakdown. Tongue-type calcaneus fractures are longitudinal fractures that exit the calcaneal tuberosity posteriorly and involve a portion of the articular surface. This requires the emergency physician to understand the radiographic morphology of the fracture as well as the clinical signs of skin compromise. Pathology Calcaneal fractures can be divided broadly into two types depending on whether there is articular involvement of the subtalar joint 2,7,8: extra-articular: 25-30% anterior calcaneal process fracture Federal government websites often end in .gov or .mil. Curr Probl Diagn Radiol 36(1):110, Carr JB (1993) Mechanism and pathoanatomy of the intraarticular calcaneal fracture. -, AJR Am J Roentgenol. Epub 2022 Jan 5. J Orthop Case Rep. 2019;9(2):11-14. doi: 10.13107/jocr.2250-0685.1358. and transmitted securely. 2006 May;12(4):171-6 Calcaneal fractures account for 60% of all tarsal bone fractures. J Orthop Trauma 12(7):469473, Benito-Ruiz J, Yoon T, Guisantes-Pintos E, Monner J, Serra-Renom JM (2004) Reconstruction of soft-tissue defects of the heel with local fasciocutaneous flaps. Would you like email updates of new search results? 2004 Apr;52(4):380-4 This procedure is used to correct a "tongue-type" fracture of the calcaneus (the heel bone). Objective: To define the pathoanatomy of the tongue-type calcaneus fracture and assess the appropriateness of percutaneous techniques in addressing all planes of deformity in this injury. Early recognition by the emergency physician and prompt operative repair prevent further injury and obviate the need for surgical soft tissue coverage or potential amputation. 2 Normal lateral radiograph of the calcaneus. CAS Feng Y, Yu Y, Shui X, Ying X, Cai L, Hong J. Orthopedics. Accessibility official website and that any information you provide is encrypted Sanders et al.'s [13] original description of intraarticular calcaneal fracture classification was based on coronal and axial CT cross-sections with the widest undersurface of the posterior facet of the talus (Fig. FOIA Am J Emerg Med 31(7):1151.e11531151.e1154, Daftary A, Haims AH, Baumgaertner MR (2005) Fractures of the calcaneus: a review with emphasis on CT. Radiographics 25(5):12151226, Gardner MJ, Nork SE, Barei DP, Kramer PA, Sangeorzan BJ, Benirschke SK (2008) Secondary soft tissue compromise in tongue-type calcaneus fractures. Six soft tissue coverage procedures and one amputation resulted. 2021 Nov 9;11:59. doi: 10.25259/JCIS_142_2021. Before This site needs JavaScript to work properly. and transmitted securely. Bethesda, MD 20894, Web Policies Due to the potential for soft-tissue compromise these injuries can . Accessibility Intra-articular tongue-type fractures of the calcaneus: anatomy, injury patterns, and an approach to management. 2005 Sep-Oct;25(5):1215-26 Imaging interpretation and clinical management of these fractures are discussed. Epub 2017 Dec 11. Tongue-type calcaneus fractures are longitudinal fractures that exit the calcaneal tuberosity posteriorly and involve a portion of the articular surface. Management of intra-articular fracture of calcaneus by combined percutaneous and minimal internal fixation. Fig. An official website of the United States government. Calcaneal fractures account for 60% of all tarsal bone fractures. An official website of the United States government. PubMed Acta Radiol 51(4):438454, Soeur R, Remy R (1975) Fractures of the calcaneus with displacement of the thalamic portion. Foot Ankle Orthop. and transmitted securely. A case of a tongue-type calcaneus fracture with a posteromedial dislocation of the calcaneal posterior facet and tuberosity is presented. Bethesda, MD 20894, Web Policies Soft tissue complications following calcaneal fractures. Conclusion: 53(3):279281, Janzen DL, Connell DG, Munk PL, Buckley RE, Meek RN, Schechter MT (1992) Intraarticular fractures of the calcaneus: value of CT findings in determining prognosis. doi: 10.1016/j.injury.2004.07.012. Taha T, Mahmoud K, Attia AK, Mekhaimar MM. PubMedGoogle Scholar. This site needs JavaScript to work properly. Emerg Radiol. Please enable it to take advantage of the complete set of features! Intra-articular tongue-type fractures may develop skin breakdown and often require urgent surgical reduction and fixation. Computed Tomography for Calcaneal Fractures: Adding Value to the Radiology Report. official website and that any information you provide is encrypted Bhler angle Annotated image Annotated image Lateral (annotated) Reduced Bhler angle is shown in red. Patients/participants: The authors declare that they have no conflict of interest. 2014 Oct;28(10):551-63. doi: 10.1097/BOT.0000000000000169. Would you like email updates of new search results? 2013 Jan;11(23):70-5. Design: Google Scholar, Snoap T, Jaykel M, Williams C, Roberts J (2017) Calcaneus fractures: a possible musculoskeletal emergency. J Bone Joint Surg Br 57(4):413421, Badillo K, Pacheco JA, Padua SO, Gomez AA, Colon E, Vidal JA (2011) Multidetector CT evaluation of calcaneal fractures. Emergency Radiology Strauss EJ, Petrucelli G, Bong M, Koval KJ, Egol KA. Blisters associated with lower-extremity fracture: results of a prospective treatment protocol. MeSH Authors of section Authors. Download Citation | Tongue-Type Calcaneus Fractures | Tongue-type calcaneus fractures present a challenge to orthopedic surgeons. HHS Vulnerability Disclosure, Help 2013 Jun 5;95(11):995-1000. doi: 10.2106/JBJS.L.01498. Type II or beak fractures are uncommon. Objectives: Open wounds occur with calcaneus fracture from direct application of force and from tearing along the medial side of the fracture as the tuberosity displaces laterally. J Biomech 28(3):269279, Sangeorzan BJ, Ananthakrishnan D, Tencer AF (1995) Contact characteristics of the subtalar joint after a simulated calcaneus fracture. Discussion: Skin compromise complicates a large percentage of these injuries because of the thin layer of soft tissue and superficial nature of the fracture. (1998) The Essex-Lopresti reduction for calcaneal fractures revisited. 8600 Rockville Pike This is a preview of subscription content, access via your institution. -, Emerg Radiol. volume26,pages 6774 (2019)Cite this article. this may result in a tongue-type calcaneus fracture (or a de- pressedvariant)[20,23](Fig.3).Thetongue-typefracturecan result in superior and posterior displacement of the displaced Fifty-six displaced Sanders 2B and 2C tongue-type calcaneus fractures identified from an initial cohort of 1118 calcaneus fractures treated over a 16-year period. Disclaimer, National Library of Medicine 2018 Feb;49(2):425-429. doi: 10.1016/j.injury.2017.12.008. Minimally-invasive treatment of calcaneal fractures. 2022 Springer Nature Switzerland AG. Calcaneal Avulsion Fractures: An Often Forgotten Diagnosis. -, Ann Plast Surg. Snoap T, Jaykel M, Williams C, Roberts J. J Emerg Med. Eric A. sharing sensitive information, make sure youre on a federal J Nepal Health Res Counc. A staged treatment plan for the management of Type II and Type IIIA open calcaneus fractures. Before Knowledge of this deformity may aid in achieving successful closed reduction when using the Essex-Lopresti maneuver or other less invasive techniques. Bookshelf Unable to load your collection due to an error, Unable to load your delegates due to an error. Emerg Radiol 23(4):357363, Golshani A, Zhu L, Cai C, Beckmann NM (2017) Incidence and association of CT findings of ankle tendon injuries in patients presenting with ankle and hindfoot fractures. Traditionally, tongue-type calcaneal fractures have been treated using screw fixation or tension band wiring. Rev Bras Ortop. 2004 Sep;35 Suppl 2:SB55-63. J Clin Imaging Sci. White, E.A., Skalski, M.R., Matcuk, G.R. [Long-term results of calcaneal fracture treatment by open reduction and internal fixation using a calcaneal locking compression plate from an extended lateral approach]. Tongue-type fractures are unusual calcaneal fractures that produce an unique and relatively uncommon injury pattern to the bone and soft tissues, due to the separation of the calcaneal tuberosity into superior and inferior fragments. The subtalar joint is crucial for normal foot and ankle function. Preparation. https://doi.org/10.1007/s10140-018-1629-4. Percutaneous Cannulated Screw Fixation vs. Plating With Minimally Invasive Longitudinal Approach After Closed Reduction for Intra-Articular Tongue-Type Calcaneal Fractures: A Retrospective Cohort Study. Epub 2018 Jul 30. Emerg Radiol 12(4):171176, Gilmer PW, Herzenberg J, Frank JL, Silverman P, Martinez S, Goldner JL (1986) Computerized tomographic analysis of acute calcaneal fractures. Bilateral fractures of the calcaneus occur approximately 10% of the time. We reviewed cross-sectional imaging and documented the presence of a varus/valgus (coronal plane) or adduction/abduction (axial plane) position of the tongue fragment in relation to the intact posterior facet, with greater than 10 degrees of angulation being diagnostic of displacement. An official website of the United States government. Modification of the sinus tarsi approach for open reduction and plate fixation of intra-articular calcaneus fractures: the limits of proximal extension based upon the vascular anatomy of the lateral calcaneal artery. 2005 Sep-Oct;25(5):1215-26. doi: 10.1148/rg.255045713. Ankle radiographs revealed a tongue-type calcaneal fracture. Syros A, Perez J, Hodgens BH, Boden AL, Constantinescu DS, Smith B, Davies JP, Steinlauf S. J Orthop. The pressure of the displaced fragment compromising blood flow to the overlying soft tissues is reflected by the ecchymosis and skin blanching present at the time of presentation. Epub 2016 Apr 27. Would you like email updates of new search results? A reduced Bhler angle is noted (see annotated image below). 1990 Oct;13(10):1091-100. doi: 10.3928/0147-7447-19901001-05. The .gov means its official. Clin Interv Aging. . This displacement may threaten the posterior soft tissue envelope. Early recognition by the emergency physician and prompt operative repair prevent further injury and obviate the need for surgical soft tissue coverage or potential amputation. FOIA Tongue-type calcaneus fractures are longitudinal fractures that exit the calcaneal tuberosity posteriorly and involve a portion of the articular surface. 8,10 They can occur as an isolated fracture line or as part of a more complex, intra-articular calcaneus fracture pattern. Materials and Methods A total of 77 patients with intra-articular tongue-type calcaneal fractures between September 2015 and July 2019 were included in this study. Bhler angle From the case:Calcaneal fracture - tongue-type Annotated image Loading Stack - Unable to load your collection due to an error, Unable to load your delegates due to an error. 2019 Feb;26(1):67-74. doi: 10.1007/s10140-018-1629-4. doi: 10.3928/01477447-20160421-05. A high incidence (21%) of posterior skin compromise occurs in tongue-type calcaneus fractures. White EA, Skalski MR, Matcuk GR Jr, Heckmann N, Tomasian A, Gross JS, Patel DB. Fracture lines can be seen near the Achilles tendon attachment and the posterior facet of the calcaneus (intra-articular). Epub 2016 Sep 19. This fracture occurs as a result of the Achilles tendon, which is extremely strong, avulsing a posterior fragment which may be either intra- or extraarticular. Tongue Type Calcaneal Fracture - Discussion: - if secondary frx line travels parallel w/ plantar aspect of foot, exiting at posterior border of the calcaneus, tounge frx will develop; - secondary fracture line extends posteriorly from superior part of primary frx line (at crucial angle), creating 1 single posterior, superior, & lateral fragment; 8600 Rockville Pike Setting: FOIA Share. Recognition of the imaging findings, accurate interpretation, and timely communication may prevent devastating clinical outcomes including soft tissue coverage procedures and amputation. HHS Vulnerability Disclosure, Help 2006 Oct;20(9):618-22. doi: 10.1097/01.bot.0000249420.30736.91. Intra-articular tongue-type fractures may develop skin breakdown and often require urgent surgical reduction and fixation. Percutaneous Cannulated Screw Fixation vs. Plating With Minimally Invasive Longitudinal Approach After Closed Reduction for Intra-Articular Tongue-Type Calcaneal Fractures: A Retrospective Cohort Study. This site needs JavaScript to work properly. https://doi.org/10.1007/s10140-018-1629-4, DOI: https://doi.org/10.1007/s10140-018-1629-4. Clin Orthop Relat Res 290:3640, Mitchell MJ, McKinley JC, Robinson CM (2009) The epidemiology of calcaneal fractures. 2022 Apr 4;9:854210. doi: 10.3389/fsurg.2022.854210. Of 954 patients with calcaneal fractures, 139 tongue-type calcaneus fractures in 127 patients formed the study group. fracture line when a longitudinal tongue-type fracture line traverses the lateral calcaneus, characterizing joint depres-sion fractures, and fully delineating intra-articular fracture involvement of the anterior process [5]. government site. The https:// ensures that you are connecting to the Bethesda, MD 20894, Web Policies HHS Vulnerability Disclosure, Help A joint-preserving osteotomy with axial realignment is a treatment option for malunited tongue-type calcaneal fractures encountered early on, before the development of . Careers. Sanders R, Vaupel ZM, Erdogan M, Downes K. J Orthop Trauma. Careers. The site is secure. Federal government websites often end in .gov or .mil. Calcaneal avulsion fractures: complications from delayed treatment. The management of this fracture is distinctly different from other calcaneal fractures, as urgent surgery may be required [ 12 ]. Federal government websites often end in .gov or .mil. Google Scholar, Chhabra N, Sherman SC, Szatkowski JP Tongue-type calcaneus fractures: a threat to skin. PMC 6 A 19-year-old man after a fall from height. PMC To define the pathoanatomy of the tongue-type calcaneus fracture and assess the appropriateness of percutaneous techniques in addressing all planes of deformity in this injury. The Essex-Lopresti classification system was developed in 1952. 2021 Feb 15;16:275-280. doi: 10.2147/CIA.S291497. Several radiographic features of intra-articular fractures have been shown to correlate with the outcome. In preparation for the procedure, the patient is positioned and anesthesia is administered. 2022 Apr 4;9:854210. doi: 10.3389/fsurg.2022.854210. A reduced Bhler angle is noted (see annotated image below). The calcaneus is the most commonly fractured tarsal bone and accounts for about 2% of all fractures 2 and ~60% of all tarsal fractures 3. Imaging interpretation and clinical management of these fractures are discussed. Please enable it to take advantage of the complete set of features! Retrospective cohort. Google Scholar, Greenspan A (2014) Orthopedic imaging: a practical approach: Lippincott Williams & Wilkins, Bohl DD, Ondeck NT, Samuel AM, Diaz-Collado PJ, Nelson SJ, Basques BA, Leslie MP, Grauer JN (2017) Demographics, mechanisms of injury, and concurrent injuries associated with calcaneus fractures: a study of 14 516 patients in the American College of Surgeons National Trauma Data Bank. Fractures of the calcaneus: a review with emphasis on CT. Calcaneal fracture maps and their determinants. Delayed Soft Tissue Necrosis in an Atypical Closed Calcaneal Fracture: A Case Report. 2012 Apr;20(4):253-8. doi: 10.5435/JAAOS-20-04-253. b Sagittal CT shows the fracture extends into the posterior facet with minimal displacement (arrow) - "Intra-articular tongue-type fractures of the calcaneus: anatomy, injury patterns, and an approach to management" Injury. Operative treatment of displaced intraarticular calcaneal fractures: long-term (10-20 Years) results in 108 fractures using a prognostic CT classification. MeSH sharing sensitive information, make sure youre on a federal University level I trauma center. government site. 2008 Dec;75(6):457-64. Skelet Radiol 45(7):977988, Strauss EJ, Petrucelli G, Bong M, Koval KJ, Egol KA (2006) Blisters associated with lower-extremity fracture: results of a prospective treatment protocol. Computed Tomography for Calcaneal Fractures: Adding Value to the Radiology Report. Eur Rev Med Pharmacol Sci 19(22):42204226, CAS sharing sensitive information, make sure youre on a federal PubMed This site needs JavaScript to work properly. White. The Treatment of Avulsion Fracture of the Calcaneal Tuberosity: A New Technique of 180-Degree Annular Internal Fixation. This calcaneus fracture is a tongue-type injury and associated with significant soft-tissue compromise. Intra-articular Calcaneus Fractures: Current Concepts Review. Foot 27:13, Ballard DH, Campbell KJ, Blanton LE, Williams JT, Sangster G, Hollister AM, Simoncini AA (2016) Tendon entrapments and dislocations in ankle and hindfoot fractures: evaluation with multidetector computed tomography. Minimally invasive treatment and internal fixation vs. extended lateral approach in calcaneus fractures of thalamic interest. -, Radiographics. official website and that any information you provide is encrypted Although they are often associated to high-energy injuries in younger individuals, this type of fracture can also occur due to minor trauma. They are often superiorly displaced. Ankle radiographs revealed a tongue-type calcaneal fracture. J Orthop Trauma 9(3):251258, Calleja M, Connell DA (2010) The Achilles tendon. Journal of foot and ankle research 7(1):19, Article Closed Reduction and Percutaneous Fixation of Calcaneal Fractures in Children. A 62-year-old female with tongue-type calcaneal fracture due to minor trauma is presented, which is often associated to high-energy injuries in younger individuals. sharing sensitive information, make sure youre on a federal The Bohler angle measures 9. 8600 Rockville Pike Learn more about Institutional subscriptions, Stoller DW, Tirman PF, Bredella MA, Beltran S (2004) Diagnostic imaging: orthopaedics: Amirsys Salt Lake City, Eiff MP, Hatch R, Higgins MK (2012) Fracture management for primary care Saunders/Elsevier, Cave EF (1963) 7 fracture of the Os Calcis-the problem in general. Bookshelf AJR Am J Roentgenol 208(2):373379, Tresley J, Subhawong TK, Singer AD, Clifford PD (2016) Incidence of tendon entrapment and dislocation with calcaneus and pilon fractures on CT examination. Intraarticular fractures of the calcaneus: diagnosis and surgical management. government site. Because many calcaneus fractures are splinted initially and immobilized for several weeks until swelling resolves, failure to acutely recognize the potential for posterior skin breakdown may lead to severe soft tissue morbidity. Objective: White EA, Skalski MR, Matcuk GR Jr, Heckmann N, Tomasian A, Gross JS, Patel DB. Google Scholar, Matherne TH, Tivorsak T, Monu JU (2007) Calcaneal fractures: what the surgeon needs to know. Foot Ankle Clin. 1992 Jun;158(6):1271-4 Please enable it to take advantage of the complete set of features! If it is not reduced accurately, weakness from Achilles tendon dysfunction will occur. eCollection 2021. Correspondence to A contemporary review. Would you like email updates of new search results? The site is secure. Objectives: J Emerg Med 52(1):2833, Watson TS (2007) Soft tissue complications following calcaneal fractures. Secondary soft tissue injury can also occur from pressure of the displaced fracture fragments. AJR Am J Roentgenol. J Clin Imaging Sci. Yu Q, Li Z, Li J, Yu Q, Zhang L, Liu D, Zhang M, Tang P. J Orthop Surg Res. Federal government websites often end in .gov or .mil. Bethesda, MD 20894, Web Policies 2016 Jul 1;39(4):e744-8. White,George R. Matcuk Jr,Nathanael Heckmann,Anderanik Tomasian,Jordan S. Gross&Dakshesh B. Patel, Palmer College of Chiropractic, West Campus, San Jose, USA, You can also search for this author in Provided by the Springer Nature SharedIt content-sharing initiative, Over 10 million scientific documents at your fingertips, Not logged in government site. Injury. Secondary soft tissue compromise in tongue-type calcaneus fractures. Radiographics 31(1):8192, Essex-Lopresti P (1993) The mechanism, reduction technique, and results in fractures of the os calcis, 1951-52. Allegra PR, Rivera S, Desai SS, Aiyer A, Kaplan J, Gross CE. Recognition of the imaging findings, accurate interpretation, and timely communication may prevent devastating clinical outcomes including soft tissue coverage procedures and amputation. eCollection 2021. - 46.32.249.112. Fracture lines can be seen near the Achilles tendon attachment and the posterior facet of the calcaneus (intra-articular). 2015 Nov;205(5):1061-7. doi: 10.2214/AJR.14.14190. AJR Am J Roentgenol 158(6):12711274, Rubino R, Valderrabano V, Sutter PM, Regazzoni P (2009) Prognostic value of four classifications of calcaneal fractures. MeSH CAS type 2c: involves one primary fracture line that courses through the medial aspect of the posterior facet and is accompanied by a transverse fracture through the body of the calcaneus; this fracture is often accompanied by one or more accessory fracture lines that do not involve the posterior articular facet Tongue-type fractures make up 25-35% of intra-articular calcaneal fractures [ 10, 11 ]. Publication types Case Reports MeSH terms Accidental Falls Bone Screws Calcaneus / diagnostic imaging Extreme tongue-type (beak) fracture of the calcaneus body. type 2c: involves one primary fracture line that courses through the medial aspect of the posterior facet and is accompanied by a transverse fracture through the body of the calcaneus; this fracture is often accompanied by one or more accessory fracture lines that do not involve the posterior articular facet 2017 Jan;52(1):28-33. doi: 10.1016/j.jemermed.2016.07.085. J Orthop Trauma 22(7):439445, Hess M, Booth B, Laughlin RT (2008) Calcaneal avulsion fractures: complications from delayed treatment. J Foot Ankle Surg 56(5):11141120, Sharr PJ, Mangupli MM, Winson IG, Buckley RE (2016) Current management options for displaced intra-articular calcaneal fractures: non-operative, ORIF, minimally invasive reduction and fixation or primary ORIF and subtalar arthrodesis. In this work, we aim to present a technique guide for an alternative approach to fixation of these fractures given the high potential for failure with traditional methods. Sanders 2B fractures were more likely to be in a position of valgus and adduction than those of 2C fractures. Part of Springer Nature. PMC -. Disclaimer, National Library of Medicine Intra-articular tongue-type fractures of the calcaneus: anatomy, injury patterns, and an approach to management. Acta Chir Orthop Traumatol Cech. 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