Design: 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" 1990 Oct;13(10):1091-100. doi: 10.3928/0147-7447-19901001-05. PubMed Accessibility A joint-preserving osteotomy with axial realignment is a treatment option for malunited tongue-type calcaneal fractures encountered early on, before the development of . This is a preview of subscription content, access via your institution. PubMed Cao Y, Xu X, Guo Y, Cui Z, Zhao Y, Gao S, Tian Y, Lv Y, Zhou F. Front Surg. An official website of the United States government. Eur Rev Med Pharmacol Sci 19(22):42204226, CAS Disclaimer, National Library of Medicine The Treatment of Avulsion Fracture of the Calcaneal Tuberosity: A New Technique of 180-Degree Annular Internal Fixation. All tongue-type calcaneus fractures treated at 1 institution between 2002 and 2007 were identified from a trauma registry. Would you like email updates of new search results? Fracture lines can be seen near the Achilles tendon attachment and the posterior facet of the calcaneus (intra-articular). PMC 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. Correspondence to Patients/participants: Unable to load your collection due to an error, Unable to load your delegates due to an error. The site is secure. White EA, Skalski MR, Matcuk GR Jr, Heckmann N, Tomasian A, Gross JS, Patel DB. 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. Gardner MJ, Nork SE, Barei DP, Kramer PA, Sangeorzan BJ, Benirschke SK. Of 954 patients with calcaneal fractures, 139 tongue-type calcaneus fractures in 127 patients formed the study group. Main outcome measurements: and transmitted securely. Emerg Radiol 26, 6774 (2019). 2 Normal lateral radiograph of the calcaneus. J Biomech 28(3):269279, Sangeorzan BJ, Ananthakrishnan D, Tencer AF (1995) Contact characteristics of the subtalar joint after a simulated calcaneus fracture. FOIA 2008 Feb;26(2):254.e1-4. FOIA A reduced Bhler angle is noted (see annotated image below). Patients/participants: Fifty-six displaced Sanders 2B and 2C tongue-type calcaneus fractures identified from an initial cohort of 1118 . Clipboard, Search History, and several other advanced features are temporarily unavailable. Results: Syros A, Perez J, Hodgens BH, Boden AL, Constantinescu DS, Smith B, Davies JP, Steinlauf S. J Orthop. Calcaneal fractures account for 60% of all tarsal bone fractures. They are often superiorly displaced because of the insertion of the Achilles tendon and pull of the gastroc-soleus complex. Discussion: sharing sensitive information, make sure youre on a federal 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. 2008 Dec;75(6):457-64. A reduced Bhler angle is noted (see annotated image below). Please enable it to take advantage of the complete set of features! 10,18 This requires the emergency physician to understand the radiographic morphology of the fracture as well as the clinical signs of skin compromise. 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. Google Scholar, Walters JL, Gangopadhyay P, Malay DS (2014) Association of calcaneal and spinal fractures. 1992 Jun;158(6):1271-4 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. 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. 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 Epub 2016 Apr 27. [Long-term results of calcaneal fracture treatment by open reduction and internal fixation using a calcaneal locking compression plate from an extended lateral approach]. Type II or beak fractures are uncommon. and transmitted securely. Ankle radiographs revealed a tongue-type calcaneal fracture. Six soft tissue coverage procedures and one amputation resulted. Recognition of the imaging findings, accurate interpretation, and timely communication may prevent devastating clinical outcomes including soft tissue coverage procedures and amputation. 2006 May;12(4):171-6 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. Tongue-type calcaneus fractures are longitudinal fractures that exit the calcaneal tuberosity posteriorly and involve a portion of the articular surface. De Boer AS, Van Lieshout EMM, Van 't Land F, Misselyn D, Schepers T, Den Hartog D, Verhofstad MHJ. -, Radiographics. 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. Calcaneal fractures have characteristic appearances based on the mechanism of injury and are divided into two major groups, intraarticular and extraarticular. Google Scholar, Chhabra N, Sherman SC, Szatkowski JP Tongue-type calcaneus fractures: a threat to skin. A recent retrospective cohort study by Quirine showed a lower incidence of wound problems and deep infection when . 2016 Jul 1;39(4):e744-8. Disclaimer, National Library of Medicine MeSH Accessibility doi: 10.3928/01477447-20160421-05. Epub 2018 Jul 30. Operative treatment of displaced intraarticular calcaneal fractures: long-term (10-20 Years) results in 108 fractures using a prognostic CT classification. The https:// ensures that you are connecting to the eCollection 2022. Description of Extreme tongue-type (beak) fracture of the calcaneus body. 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. 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. Intra-articular tongue-type fractures of the calcaneus: anatomy, injury patterns, and an approach to management. Intra-articular tongue-type fractures of the calcaneus: anatomy, injury patterns, and an approach to management. 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. government site. The https:// ensures that you are connecting to the PubMed Central 1975 Nov;57(4):413-21 Intraarticular fractures of the calcaneus: diagnosis and surgical management. Please enable it to take advantage of the complete set of features! Bethesda, MD 20894, Web Policies Emerg Radiol. Mehta S, Mirza AJ, Dunbar RP, Barei DP, Benirschke SK. Conclusion: eCollection 2021. PubMed Federal government websites often end in .gov or .mil. Delayed Soft Tissue Necrosis in an Atypical Closed Calcaneal Fracture: A Case Report. Intra-articular tongue-type fractures may develop skin breakdown and often require urgent surgical reduction and fixation. 2014 Oct;28(10):551-63. doi: 10.1097/BOT.0000000000000169. FOIA During this procedure, the surgeon stabilizes the bone with hardware to allow the bone to heal properly. Main outcome measurements: Calcaneal fractures account for 60% of all tarsal bone fractures. 2022 Sep 14;34:282-287. doi: 10.1016/j.jor.2022.09.009. The authors declare that they have no conflict of interest. Foot Ankle Clin 12(1):107123, Wang CL, Cheng CK, Chen CW, Lu CM, Hang YS, Liu TK (1995) Contact areas and pressure distributions in the subtalar joint. In selected cases, if the malunited joint is still in good condition, it is preserved by corrective osteotomy. Bethesda, MD 20894, Web Policies PubMed Accessibility Disclaimer, National Library of Medicine -, AJR Am J Roentgenol. An official website of the United States government. The https:// ensures that you are connecting to the J Foot Ankle Surg. 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. ACS Level I trauma center. Bhler angle Annotated image Annotated image Lateral (annotated) Reduced Bhler angle is shown in red. Tongue-type fractures of the calcaneus lead to variable amounts of displacement of the posterior tuberosity. Snoap T, Jaykel M, Williams C, Roberts J. J Emerg Med. Skin compromise complicates a large percentage of these injuries because of the thin layer of soft tissue and superficial nature of the fracture. 2021 Feb 15;16:275-280. doi: 10.2147/CIA.S291497. government site. Publication types Case Reports MeSH terms Accidental Falls Bone Screws Calcaneus / diagnostic imaging 2021 Nov 9;11:59. doi: 10.25259/JCIS_142_2021. Federal government websites often end in .gov or .mil. 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; -, Emerg Radiol. 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. Femino JE, Vaseenon T, Levin DA, Yian EH. official website and that any information you provide is encrypted 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. 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. Results: Epub 2016 Sep 19. 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. Management of intra-articular fracture of calcaneus by combined percutaneous and minimal internal fixation. and transmitted securely. AJR Am J Roentgenol. An Open all credits. Sanders 2B fractures were more likely to be in a position of valgus and adduction than those of 2C fractures. 2015 Nov;205(5):1061-7. doi: 10.2214/AJR.14.14190. sharing sensitive information, make sure youre on a federal Clin Interv Aging. Bookshelf 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. Surgical treatment of intraarticular fractures of the calcaneus: comparison between flat plate and calcaneal plate. The https:// ensures that you are connecting to the 8600 Rockville Pike 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. - 46.32.249.112. CAS Federal government websites often end in .gov or .mil. This displacement may threaten the posterior soft tissue envelope. PubMedGoogle Scholar. Clin Orthop Relat Res 290:3640, Mitchell MJ, McKinley JC, Robinson CM (2009) The epidemiology of calcaneal fractures. Rev Bras Ortop. Provided by the Springer Nature SharedIt content-sharing initiative, Over 10 million scientific documents at your fingertips, Not logged in Secondary soft tissue injury can also occur from pressure of the displaced fracture fragments. Imaging interpretation and clinical management of these fractures are discussed. sharing sensitive information, make sure youre on a federal A high incidence (21%) of posterior skin compromise occurs in tongue-type calcaneus fractures. Occasionally, it is completely extraarticular but deserves the same operative treatment and reduction. Taha T, Mahmoud K, Attia AK, Mekhaimar MM. Type III (20%) are oblique fractures. Careers. This article reviews the anatomy of the calcaneus, as well as the clinical presentation and imaging findings of intra-articular tongue-type fractures. The site is secure. 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. Closed Reduction and Percutaneous Fixation of Calcaneal Fractures in Children. Download Citation | Tongue-Type Calcaneus Fractures | Tongue-type calcaneus fractures present a challenge to orthopedic surgeons. eCollection 2020 Jul. Foot Ankle Spec 10(5):402410, Article Clin Orthop Relat Res 30:6466, Article 2008 Aug;22(7):439-45. doi: 10.1097/BOT.0b013e31817ace7e. Foot Ankle Surg 22(1):18, Keck School of Medicine, University of Southern California, Los Angeles, USA, Eric A. Setting: 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]. Google Scholar, Matherne TH, Tivorsak T, Monu JU (2007) Calcaneal fractures: what the surgeon needs to know. 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. Extreme tongue-type (beak) fracture of the calcaneus body. Secondary soft tissue injury can also occur from pressure of the displaced fracture fragments. Occasionally, it is completely extraarticular but deserves the same operative treatment and reduction. The subtalar joint is crucial for normal foot and ankle function. 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. 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. 2022 Mar;23(3):196. doi: 10.3892/etm.2022.11119. et al. Those injuries that were associated with posterior, secondary soft tissue breakdown were identified and compared to those without breakdown. Foot Ankle Orthop. This site needs JavaScript to work properly. eCollection 2021. White. Emerg Radiol. 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. Bilateral fractures of the calcaneus occur approximately 10% of the time. 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. Fractures of the calcaneus: a review with emphasis on CT. Calcaneal fracture maps and their determinants. 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. sharing sensitive information, make sure youre on a federal This article reviews the anatomy of the calcaneus, as well as the clinical presentation and imaging findings of intra-articular tongue-type fractures. Injury. 2005 Sep-Oct;25(5):1215-26. doi: 10.1148/rg.255045713. 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. Calcaneal avulsion fractures: complications from delayed treatment. Am J Emerg Med 26(2):254 e251, Article https://doi.org/10.1007/s10140-018-1629-4. Recognition of the imaging findings, accurate interpretation, and timely communication may prevent devastating clinical outcomes including soft tissue coverage procedures and amputation. official website and that any information you provide is encrypted Emergency Radiology 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. Would you like email updates of new search results? Ankle radiographs revealed a tongue-type calcaneal fracture. Management of calcaneal tuberosity fractures. Banerjee R, Chao JC, Taylor R, Siddiqui A. J Am Acad Orthop Surg. eCollection 2022 Nov-Dec. Cursaru A, Creu B, erban B, Iordache S, Popa M, Smarandache CG, Orban C, Crstoiu C. Exp Ther Med. Traditionally, tongue-type calcaneal fractures have been treated using screw fixation or tension band wiring. 2022 Springer Nature Switzerland AG. CAS Orthopedics. Calcaneal Avulsion Fractures: An Often Forgotten Diagnosis. 2017 Jan;52(1):28-33. doi: 10.1016/j.jemermed.2016.07.085. 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 Displacement of the sustentacular fragment in intra-articular calcaneal fractures. Fracture lines can be seen near the Achilles tendon attachment and the posterior facet of the calcaneus (intra-articular). 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. Discussion: Tongue-type calcaneal fractures and tuberosity fractures must be triaged appropriately within the first few hours of presentation to prevent skin compromise. Authors of section Authors. Preparation. -, Ann Plast Surg. PMC Foot 19(4):197200, Article Clipboard, Search History, and several other advanced features are temporarily unavailable. 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. 8600 Rockville Pike 6 A 19-year-old man after a fall from height. Computed Tomography for Calcaneal Fractures: Adding Value to the Radiology Report. Careers. Setting: The emergent nature of this entity has received little attention in the radiology literature. Tongue-type fractures make up 25-35% of intra-articular calcaneal fractures [ 10, 11 ]. Patient demographics, comorbidities, injury mechanism, fracture displacement, and time to presentation were evaluated. HHS Vulnerability Disclosure, Help The site is secure. The normal value for the angle of Gissane is between 120 and 145 - "Intra-articular tongue-type fractures of the calcaneus: anatomy, injury patterns, and an approach to management" This calcaneus fracture is a tongue-type injury and associated with significant soft-tissue compromise. and transmitted securely. Before 2012 Apr;20(4):253-8. doi: 10.5435/JAAOS-20-04-253. 2010 Mar;24(3):142-7. doi: 10.1097/BOT.0b013e3181b5c0a4. 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. 2019 Feb;26(1):67-74. doi: 10.1007/s10140-018-1629-4. J Orthop Trauma. J Orthop Trauma. AJR Am J Roentgenol 158(6):12711274, Rubino R, Valderrabano V, Sutter PM, Regazzoni P (2009) Prognostic value of four classifications of calcaneal fractures. This site needs JavaScript to work properly. Keywords: Injury. Although they are often associated to high-energy injuries in younger individuals, this type of fracture can also occur due to minor trauma. Recognition of the imaging findings, accurate interpretation, and timely communication may prevent devastating clinical outcomes including soft tissue coverage procedures and amputation. Unable to load your collection due to an error, Unable to load your delegates due to an error. 2020 Jul 28;5(3):2473011420927334. doi: 10.1177/2473011420927334. Ideally, the CT scans are formatted in two planes: the semicoronal or oblique coronal plane, which is perpendicular . When assessing for displacement and angulation in the coronal plane, 98% of tongue fragments were either in a position of valgus (77%) or neutral (21%), with a mean valgus angulation of 17.3 degrees. They are often superiorly displaced. Would you like email updates of new search results? Soft tissue complications and timing of surgery in patients with a tongue-type displaced intra-articular calcaneal fracture: An international retrospective cohort study. -. Types IV and V(60%) involve the subtalar joint. HHS Vulnerability Disclosure, Help Acta Radiol 51(4):438454, Soeur R, Remy R (1975) Fractures of the calcaneus with displacement of the thalamic portion. Although mechanism, displacement, and time to presentation were significantly correlated with posterior skin involvement, the surgeon should be aware of this potential complicating factor in all tongue-type fractures. Executive Editors. J Clin Imaging Sci. Clipboard, Search History, and several other advanced features are temporarily unavailable. J Orthop Trauma. 2007 Mar;12(1):107-23. doi: 10.1016/j.fcl.2006.12.003. Blisters associated with lower-extremity fracture: results of a prospective treatment protocol. Intervention: Minimally invasive treatment and internal fixation vs. extended lateral approach in calcaneus fractures of thalamic interest. The .gov means its official. Fig. Objectives: Tongue-type calcaneus fractures are longitudinal fractures that exit the calcaneal tuberosity posteriorly and involve a portion of the articular surface. HHS Vulnerability Disclosure, Help Intra-articular tongue-type fractures may develop skin breakdown and often require urgent surgical reduction and fixation. eCollection 2017 Jan-Feb. Careers. Berberian W, Sood A, Karanfilian B, Najarian R, Lin S, Liporace F. J Bone Joint Surg Am. Disclaimer, National Library of Medicine Objective: Intra-articular tongue-type fractures may develop skin breakdown and often require urgent surgical reduction and fixation. A contemporary review. MeSH The site is secure. Clipboard, Search History, and several other advanced features are temporarily unavailable. 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. Am J Emerg Med. Allegra PR, Rivera S, Desai SS, Aiyer A, Kaplan J, Gross CE. Foot Ankle Int 30(3):229238, Johnson PT, Fayad LM, Fishman EK (2006) Sixteen-slice CT with volumetric analysis of foot fractures. volume26,pages 6774 (2019)Cite this article. official website and that any information you provide is encrypted Bookshelf 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 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 ]. Yu Q, Li Z, Li J, Yu Q, Zhang L, Liu D, Zhang M, Tang P. J Orthop Surg Res. Sanders R, Vaupel ZM, Erdogan M, Downes K. J Orthop Trauma. Acta Chir Orthop Traumatol Cech. doi: 10.1016/j.ajem.2007.04.033. The tongue-type calcaneus fracture most often displaces into a position of plantarflexion, valgus, and adduction. Journal of foot and ankle research 7(1):19, Article doi: 10.1016/j.injury.2004.07.012. Due to the potential for soft-tissue compromise these injuries can . 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. Most calcaneal fractures (70%-75%) are intraarticular and result from axial loading that produces shear and compression fracture lines. Fig. Cao Y, Xu X, Guo Y, Cui Z, Zhao Y, Gao S, Tian Y, Lv Y, Zhou F. Front Surg. A case of a tongue-type calcaneus fracture with a posteromedial dislocation of the calcaneal posterior facet and tuberosity is presented. Type V fractures are comminuted fractures with a centrally depressed fragment. 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. Bethesda, MD 20894, Web Policies 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. government site. Bethesda, MD 20894, Web Policies Bhler angle From the case:Calcaneal fracture - tongue-type Annotated image Loading Stack - Careers. 2022 Apr 4;9:854210. doi: 10.3389/fsurg.2022.854210. Part of Springer Nature. This site needs JavaScript to work properly. Design: Retrospective cohort. (1998) The Essex-Lopresti reduction for calcaneal fractures revisited. a Lateral radiograph shows a comminuted calcaneal fracture with a tongue-type component (arrow). 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 2013 Jun 5;95(11):995-1000. doi: 10.2106/JBJS.L.01498. Knowledge of this deformity may aid in achieving successful closed reduction when using the Essex-Lopresti maneuver or other less invasive techniques. 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. The Bohler angle measures 9. Feng Y, Yu Y, Shui X, Ying X, Cai L, Hong J. Orthopedics. Foot Ankle Clin. HHS Vulnerability Disclosure, Help 2005 Sep-Oct;25(5):1215-26 2016 Dec 29;52(1):29-34. doi: 10.1016/j.rboe.2016.05.007. 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. 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. Sinus tarsi approach in high-risk patients with displaced intra-articular calcaneus fractures: A case series. Epub 2022 Jan 5. The Essex-Lopresti classification system was developed in 1952. Please enable it to take advantage of the complete set of features! 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. If it is not reduced accurately, weakness from Achilles tendon dysfunction will occur. J Clin Imaging Sci. 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. Strauss EJ, Petrucelli G, Bong M, Koval KJ, Egol KA. J Orthop Case Rep. 2019;9(2):11-14. doi: 10.13107/jocr.2250-0685.1358. White EA, Skalski MR, Matcuk GR Jr, Heckmann N, Tomasian A, Gross JS, Patel DB. eCollection 2021. The .gov means its official. Those with threatened posterior skin who were treated emergently with percutaneous reduction did not progress to soft tissue compromise. Intra-articular Calcaneus Fractures: Current Concepts Review. Unable to load your collection due to an error, Unable to load your delegates due to an error. PMC 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. Patients/participants: The Essex-Lopresti reduction for calcaneal fractures revisited. Bookshelf 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. Accessibility Joseph Schatzker. Ann Plast Surg 52(4):380384, Khai Luen K, Wan Sulaiman WA (2017) Functional outcomes after heel pad reconstruction: a review of 7 cases. Would you like email updates of new search results? 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. 8600 Rockville Pike MeSH Federal government websites often end in .gov or .mil. Calcaneus Fractures - Trauma - Orthobullets orthoBULLETS MBBULLETSStep 1For 1st and 2nd Year Med Students MBBULLETSStep 2 & 3For 3rd and 4th Year Med Students ORTHOBULLETSOrthopaedic Surgeons & Providers JOIN NOWLOGIN Home Topics Techniques Cards QBank Evidence Cases Videos Podcasts Groups Products Trauma Spine Shoulder & Elbow Knee & Sports An official website of the United States government. 2022 Jan 21;17(1):39. doi: 10.1186/s13018-022-02930-y. PMC eCollection 2022. Secondary soft tissue compromise in tongue-type calcaneus fractures. The .gov means its official. Google Scholar, Snoap T, Jaykel M, Williams C, Roberts J (2017) Calcaneus fractures: a possible musculoskeletal emergency. 2018 Feb;49(2):425-429. doi: 10.1016/j.injury.2017.12.008. FOIA Bookshelf Radiographics. Radiographics 31(1):8192, Essex-Lopresti P (1993) The mechanism, reduction technique, and results in fractures of the os calcis, 1951-52. and osteoarticular radiology . Richard Buckley, Andrew Sands. 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