Calcaneal Fracture Essay

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The etiology of calcaneal fracture is usually high energy trauma such as fall from a height or motor vehicle crash 1,2.
Intra articular fractures of calcaneus occurs following eccentric loading of the talus on the calcaneus.(fig 5.1) The severity, type and location of fracture are determined by the position of the foot, the direction and magnitude of applied force and quality of bone 49.
Eccentric axial loading of talus on calcaneus produces a primary shear line that is parallel to posterolateral edge of talus and passes through posterior calcaneal facet. This primary fracture line separates the calcaneum in to two parts viz posterolateral and anteromedial (fig 5.1). Each fragment consists of a portion of posterior facet. The amount of posterior …show more content…

As the primary fracture line develops, the body of calcaneum displaces laterally and proximally which impacts the lateral portion of the posterior facet against the posterior lateral edge of talus leading to shearing off of the lateral wall and development of posterior secondary fracture line.
C. As the body of calcaneum progresses proximally and lateral, it causes the superolateral fragment to rotate medially and to impact into spongy calcaneous bone which sweeps out the sheared off lateral wall fragment and results in commounited fragments impinging into the peronal tendon space against fibula.
Source: Paley D, Hall H. Calcaneal fracture controversies Can we put Humpty Dumpty together again? Orthop Clin North Am. 1989 Oct;20(4):665-77 Fig 5.2. Multiple views showing primary and secondary fracture lines in calcaneum

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