1 / 20

Fracture calcaneum

Fracture calcaneum. Calcaneus fracture or heel fracture is a very common fracture of the of the foot. Functions : Supports weight of the body Acts as a spring board for locomotion . Bones of the foot . . Parts .

Patman
Télécharger la présentation

Fracture calcaneum

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Fracture calcaneum • Calcaneus fracture or heel fracture is a very common fracture of the of the foot. Functions : • Supports weight of the body • Acts as a spring board for locomotion

  2. Bones of the foot

  3. .

  4. Parts

  5. Extra-articular fractures of the body of calcaneus are caused by a fall from height. These fractures can be • undisplaced (hairline) or minimally displaced • displaced fractures in which the bone fragment has moved proximally (upwards) • comminuted (multiple bone pieces) fractures that result in widening of the bone

  6. Two types : • extra-articular or those fractures that do not involve the subtalar and calcaneo-cuboid joints • intra-articular or those fractures that involve the subtalar and calcaneo-cuboid joints • Extra-articular fractures constitute about 1/4 th of all fractures of calcaneum and they are of the following types : • tuberosity • sustentaculum tali • anterior process • medial process • body of the calcaneus

  7. Extra-articular fracture

  8. Cont… Extra-articular fractures : - • sustentaculum tali, anterior process, medial process, are caused by injuries that twist the foot. • Undisplaced fractures of the sustentaculum tali and anterior process are treated by : - • immobilization of the foot in a plaster cast for 6 to 8 weeks. • Displaced fractures are treated by surgery. • Fractures of the medial process are treated by plaster cast immobilization for 4 to 6 weeks.

  9. This x ray shows a undisplaced extra-articular fracture of the body of calcaneus. Red arrows point to the fracture lines.

  10. Intra-articular fractures • are caused by • vertical loading force on the calcaneus, such as fall from height. • constitute the remaining 3/4 th of calcaneal fractures. • Essex-Lopresti classification : - • tongue type • joint depression type

  11. Essex – lopreti`s classification

  12. Classification • Classification of intra-articular fractures according to Sanders using CT scanning • Type 1 are undisplaced • Type 2 are two part or split fractures • Type 3 are 3 part or split depression • Type 4 are comminuted or having multiple fragments

  13. Symptoms • severe pain and rapid swelling inability to walk or patient walks on his toes • dark reddish discolouration of the sole and skin of the heel due to seepage of blood • associated fractures of the back or the other bones of the lower limb may be present • Less severe symptoms are seen in extra-articular fractures.

  14. Diagnosis • x rays of the foot in different positions : - • X rays of the opposite uninjured foot are also taken to compare the change in the Bohler angle • CT scans may also be required for classification and better evaluation of the fracture.

  15. Fractures of the tuberosity caused by :- • a sudden forceful contraction of the calf muscles. • more common in elderly people because of osteoporosis. • Undisplaced tuberosity fractures : - • treated by plaster cast immobilization for 6 to 8 weeks. • Displaced fractures require surgery. • If surgery is not done then the calf muscles will become weak and ineffective. • After surgery a plaster cast is applied for 6 to 8 weeks.

  16. Tuberosity #

  17. Initial treatment • All calcaneus fractures (extra and intra-articular) includes : - • Bed rest • Elevation of the foot • Use of ice to reduce swelling • Anti -inflammatory medication to decrease pain and swelling

  18. Treatment According to classification : - • In Type 1 and undisplaced type 2 and 3 fractures • exercises are started as soon as the swelling decreases and pain allows. • The patient is not allowed to walk on his heel for at least 6 weeks. • Displaced type 2 and 3 fractures :- • are treated by surgery in which the fracture fragments are re-aligned and held with plate and screws. • In Type 4 fractures :- • Improve the alignment of the fracture by manipulation they are then treated similar to type 1 fractures. • In these fractures perfect anatomy can not be restored because of multiple fragments, hence the goal of treatment is to get the patient mobile as quickly as possible

  19. Complications • Immediate complications includes : - • injury to the skin, • nerves and • blood vessels by displaced fracture fragments • Compartment Syndrome in the foot • Late complications includes : - • arthritis • irritation and pressure over peroneal muscle tendons • bone spur (bony growth formed on normal bone ) formation causing heel pain

More Related