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Calcaneus Fracture, Intraarticular
Julia R. Crim, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Pathology

        TERMINOLOGY

        • Definitions

          • Constant fragment: Medial calcaneal fracture fragment that includes sustentaculum tali
          • Thalamic fragment: Depressed portion of posterior subtalar joint (PSTJ)
          • Böhler angle
            • On lateral radiograph angle between
              • Line drawn from posterior margin of calcaneal tuberosity to posterior margin of subtalar joint
              • Line drawn from anterior margin of calcaneus to posterior margin of subtalar joint
            • Normal: 20-40°
          • Angle of Gissane
            • On lateral radiograph, superior concavity of calcaneus at anterior margin of PSTJ
            • Normal: <130°
          • Shear fracture line: Sagittally oriented fracture line through calcaneus
          • Compression fracture line: Coronally oriented fracture line through calcaneus

        IMAGING

        • General Features

          • Radiographic Findings

            • CT Findings

              • Imaging Recommendations

                DIFFERENTIAL DIAGNOSIS

                  PATHOLOGY

                  • General Features

                    • Staging, Grading, & Classification

                      CLINICAL ISSUES

                      • Presentation

                        • Natural History & Prognosis

                          • Treatment

                            DIAGNOSTIC CHECKLIST

                            • Image Interpretation Pearls

                              • Reporting Tips

                                Selected References

                                1. Hsu AR et al: Advances in surgical management of intra-articular calcaneus fractures. J Am Acad Orthop Surg. 23(7):399-407, 2015
                                2. Kwaadu KY et al: Superior peroneal retinacular injuries in calcaneal fractures. J Foot Ankle Surg. 54(3):458-63, 2015
                                3. Swords MP et al: Prognostic value of computed tomography classification systems for intra-articular calcaneus fractures. Foot Ankle Int. 35(10):975-80, 2014
                                4. Crim J et al: CT assessment of the prevalence of retinacular injuries associated with hindfoot fractures. Skeletal Radiol. 42(4):487-92, 2013
                                5. Rosenthal R et al: Sequelae of underdiagnosed foot compartment syndrome after calcaneal fractures. J Foot Ankle Surg. 52(2):158-61, 2013
                                6. Sagray BA et al: Diabetic calcaneal fractures. Clin Podiatr Med Surg. 30(1):111-8, 2013
                                7. Badillo K et al: Multidetector CT evaluation of calcaneal fractures. Radiographics. 31(1):81-92, 2011
                                8. Schepers T et al: Calcaneal fracture classification: a comparative study. J Foot Ankle Surg. 48(2):156-62, 2009
                                9. Daftary A et al: Fractures of the calcaneus: a review with emphasis on CT. Radiographics. 25(5):1215-26, 2005
                                10. Sanders R: Displaced intra-articular fractures of the calcaneus. J Bone Joint Surg Am. 82(2):225-50, 2000
                                Related Anatomy
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                                Related Differential Diagnoses
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                                References
                                Tables

                                Tables

                                KEY FACTS

                                • Terminology

                                  • Imaging

                                    • Pathology

                                      TERMINOLOGY

                                      • Definitions

                                        • Constant fragment: Medial calcaneal fracture fragment that includes sustentaculum tali
                                        • Thalamic fragment: Depressed portion of posterior subtalar joint (PSTJ)
                                        • Böhler angle
                                          • On lateral radiograph angle between
                                            • Line drawn from posterior margin of calcaneal tuberosity to posterior margin of subtalar joint
                                            • Line drawn from anterior margin of calcaneus to posterior margin of subtalar joint
                                          • Normal: 20-40°
                                        • Angle of Gissane
                                          • On lateral radiograph, superior concavity of calcaneus at anterior margin of PSTJ
                                          • Normal: <130°
                                        • Shear fracture line: Sagittally oriented fracture line through calcaneus
                                        • Compression fracture line: Coronally oriented fracture line through calcaneus

                                      IMAGING

                                      • General Features

                                        • Radiographic Findings

                                          • CT Findings

                                            • Imaging Recommendations

                                              DIFFERENTIAL DIAGNOSIS

                                                PATHOLOGY

                                                • General Features

                                                  • Staging, Grading, & Classification

                                                    CLINICAL ISSUES

                                                    • Presentation

                                                      • Natural History & Prognosis

                                                        • Treatment

                                                          DIAGNOSTIC CHECKLIST

                                                          • Image Interpretation Pearls

                                                            • Reporting Tips

                                                              Selected References

                                                              1. Hsu AR et al: Advances in surgical management of intra-articular calcaneus fractures. J Am Acad Orthop Surg. 23(7):399-407, 2015
                                                              2. Kwaadu KY et al: Superior peroneal retinacular injuries in calcaneal fractures. J Foot Ankle Surg. 54(3):458-63, 2015
                                                              3. Swords MP et al: Prognostic value of computed tomography classification systems for intra-articular calcaneus fractures. Foot Ankle Int. 35(10):975-80, 2014
                                                              4. Crim J et al: CT assessment of the prevalence of retinacular injuries associated with hindfoot fractures. Skeletal Radiol. 42(4):487-92, 2013
                                                              5. Rosenthal R et al: Sequelae of underdiagnosed foot compartment syndrome after calcaneal fractures. J Foot Ankle Surg. 52(2):158-61, 2013
                                                              6. Sagray BA et al: Diabetic calcaneal fractures. Clin Podiatr Med Surg. 30(1):111-8, 2013
                                                              7. Badillo K et al: Multidetector CT evaluation of calcaneal fractures. Radiographics. 31(1):81-92, 2011
                                                              8. Schepers T et al: Calcaneal fracture classification: a comparative study. J Foot Ankle Surg. 48(2):156-62, 2009
                                                              9. Daftary A et al: Fractures of the calcaneus: a review with emphasis on CT. Radiographics. 25(5):1215-26, 2005
                                                              10. Sanders R: Displaced intra-articular fractures of the calcaneus. J Bone Joint Surg Am. 82(2):225-50, 2000