White EA, Skalski MR, Matcuk GR Jr, Heckmann N, Tomasian A, Gross JS, Patel DB. Am J Emerg Med 26(2):254 e251, Article 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" Treatment included lag screw fixation to maintain the reduction without further soft-tissue trauma. volume26,pages 6774 (2019)Cite this article. Unable to load your collection due to an error, Unable to load your delegates due to an error. Part of Springer Nature. 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. Feng Y, Yu Y, Shui X, Ying X, Cai L, Hong J. Orthopedics. FOIA 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. Clipboard, Search History, and several other advanced features are temporarily unavailable. In preparation for the procedure, the patient is positioned and anesthesia is administered. Rev Bras Ortop. Patients/participants: Syros A, Perez J, Hodgens BH, Boden AL, Constantinescu DS, Smith B, Davies JP, Steinlauf S. J Orthop. official website and that any information you provide is encrypted Management of calcaneal tuberosity fractures. 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. -. -, Emerg Radiol. 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. 1990 Oct;13(10):1091-100. doi: 10.3928/0147-7447-19901001-05. Epub 2018 Jul 30. Bookshelf Radiographics. A high incidence (21%) of posterior skin compromise occurs in tongue-type calcaneus fractures. Before HHS Vulnerability Disclosure, Help Although they are often associated to high-energy injuries in younger individuals, this type of fracture can also occur due to minor trauma. 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. 2015 Nov;205(5):1061-7. doi: 10.2214/AJR.14.14190. Blisters associated with lower-extremity fracture: results of a prospective treatment protocol. Main outcome measurements: [Long-term results of calcaneal fracture treatment by open reduction and internal fixation using a calcaneal locking compression plate from an extended lateral approach]. Patients/participants: This article reviews the anatomy of the calcaneus, as well as the clinical presentation and imaging findings of intra-articular tongue-type fractures. J Biomech 28(3):269279, Sangeorzan BJ, Ananthakrishnan D, Tencer AF (1995) Contact characteristics of the subtalar joint after a simulated calcaneus fracture. If it is not reduced accurately, weakness from Achilles tendon dysfunction will occur. The emergent nature of this entity has received little attention in the radiology literature. PMC 8600 Rockville Pike Keywords: Foot Ankle Surg 22(1):18, Keck School of Medicine, University of Southern California, Los Angeles, USA, Eric A. 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 ]. eCollection 2021. Those with threatened posterior skin who were treated emergently with percutaneous reduction did not progress to soft tissue compromise. Careers. 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 Google Scholar, Walters JL, Gangopadhyay P, Malay DS (2014) Association of calcaneal and spinal fractures. 2016 Dec 29;52(1):29-34. doi: 10.1016/j.rboe.2016.05.007. Calcaneal fractures have characteristic appearances based on the mechanism of injury and are divided into two major groups, intraarticular and extraarticular. Clipboard, Search History, and several other advanced features are temporarily unavailable. Epub 2018 Jul 30. J Orthop Trauma. 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. The https:// ensures that you are connecting to the Knowledge of this deformity may aid in achieving successful closed reduction when using the Essex-Lopresti maneuver or other less invasive techniques. Those injuries that were associated with posterior, secondary soft tissue breakdown were identified and compared to those without breakdown. Fractures of the calcaneus: a review with emphasis on CT. Calcaneal fracture maps and their determinants. et al. FOIA Intervention: Disclaimer, National Library of Medicine Foot Ankle Orthop. Occasionally, it is completely extraarticular but deserves the same operative treatment and reduction. Imaging interpretation and clinical management of these fractures are discussed. This procedure is used to correct a "tongue-type" fracture of the calcaneus (the heel bone). Journal of foot and ankle research 7(1):19, Article Federal government websites often end in .gov or .mil. official website and that any information you provide is encrypted . sharing sensitive information, make sure youre on a federal 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. The tongue-type calcaneus fracture most often displaces into a position of plantarflexion, valgus, and adduction. Intra-articular tongue-type fractures of the calcaneus: anatomy, injury patterns, and an approach to management. Epub 2016 Apr 27. MeSH The authors declare that they have no conflict of interest. Download Citation | Tongue-Type Calcaneus Fractures | Tongue-type calcaneus fractures present a challenge to orthopedic surgeons. University level I trauma center. 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. J Nepal Health Res Counc. PubMed Central Gardner MJ, Nork SE, Barei DP, Kramer PA, Sangeorzan BJ, Benirschke SK. Authors of section Authors. 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. HHS Vulnerability Disclosure, Help Joseph Schatzker. Type III (20%) are oblique fractures. White EA, Skalski MR, Matcuk GR Jr, Heckmann N, Tomasian A, Gross JS, Patel DB. Sanders R, Vaupel ZM, Erdogan M, Downes K. J Orthop Trauma. 6 A 19-year-old man after a fall from height. J Orthop Trauma. Intraarticular fractures of the calcaneus: diagnosis and surgical management. Management of intra-articular fracture of calcaneus by combined percutaneous and minimal internal fixation. official website and that any information you provide is encrypted This site needs JavaScript to work properly. A staged treatment plan for the management of Type II and Type IIIA open calcaneus fractures. 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. The site is secure. 2008 Feb;26(2):254.e1-4. Foot Ankle Clin. doi: 10.1016/j.injury.2004.07.012. 2006 May;12(4):171-6 a Lateral radiograph shows a comminuted calcaneal fracture with a tongue-type component (arrow). eCollection 2020 Jul. PMC 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. The management of this fracture is distinctly different from other calcaneal fractures, as urgent surgery may be required [ 12 ]. The Essex-Lopresti classification system was developed in 1952. 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). 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. J Orthop Case Rep. 2019;9(2):11-14. doi: 10.13107/jocr.2250-0685.1358. A case of a tongue-type calcaneus fracture with a posteromedial dislocation of the calcaneal posterior facet and tuberosity is presented. Setting: ACS Level I trauma center. eCollection 2022. Disclaimer, National Library of Medicine Most calcaneal fractures (70%-75%) are intraarticular and result from axial loading that produces shear and compression fracture lines. The .gov means its official. 8,10 They can occur as an isolated fracture line or as part of a more complex, intra-articular calcaneus fracture pattern. Fracture lines can be seen near the Achilles tendon attachment and the posterior facet of the calcaneus (intra-articular). -, Radiographics. Ankle radiographs revealed a tongue-type calcaneal fracture. 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. eCollection 2022. Calcaneus Fractures: A Possible Musculoskeletal Emergency. 8600 Rockville Pike Accessibility 2019 Feb;26(1):67-74. doi: 10.1007/s10140-018-1629-4. A reduced Bhler angle is noted (see annotated image below). 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. and osteoarticular radiology . Clipboard, Search History, and several other advanced features are temporarily unavailable. Discussion: Tongue-type calcaneal fractures and tuberosity fractures must be triaged appropriately within the first few hours of presentation to prevent skin compromise. government site. 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 Emergency Radiology An - 46.32.249.112. 2008 Dec;75(6):457-64. Cao Y, Xu X, Guo Y, Cui Z, Zhao Y, Gao S, Tian Y, Lv Y, Zhou F. Front Surg. 2022 Apr 4;9:854210. doi: 10.3389/fsurg.2022.854210. Displacement of the sustentacular fragment in intra-articular calcaneal fractures. Please enable it to take advantage of the complete set of features! Tongue-type fractures make up 25-35% of intra-articular calcaneal fractures [ 10, 11 ]. 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. Bhler angle From the case:Calcaneal fracture - tongue-type Annotated image Loading Stack - J Orthop Trauma. Emerg Radiol. J Clin Imaging Sci. 2 Normal lateral radiograph of the calcaneus. 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. PMC The .gov means its official. Federal government websites often end in .gov or .mil. J Foot Ankle Surg. -, Ann Plast Surg. doi: 10.1016/j.ajem.2007.04.033. Injury. Please enable it to take advantage of the complete set of features! During this procedure, the surgeon stabilizes the bone with hardware to allow the bone to heal properly. Unable to load your collection due to an error, Unable to load your delegates due to an error. CAS Conclusion: 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. CAS Tongue-type calcaneus fractures are longitudinal fractures that exit the calcaneal tuberosity posteriorly and involve a portion of the articular surface. Clipboard, Search History, and several other advanced features are temporarily unavailable. 1998 Sep-Oct;12(7):469-73. doi: 10.1097/00005131-199809000-00007. The site is secure. Univariate analysis and stepwise multinomial logistic regressions were used to identify significant predictors of posterior soft tissue compromise. Federal government websites often end in .gov or .mil. Occasionally, it is completely extraarticular but deserves the same operative treatment and reduction. This article reviews the anatomy of the calcaneus, as well as the clinical presentation and imaging findings of intra-articular tongue-type fractures. Taha T, Mahmoud K, Attia AK, Mekhaimar MM. Main outcome measurements: De Boer AS, Van Lieshout EMM, Van 't Land F, Misselyn D, Schepers T, Den Hartog D, Verhofstad MHJ. In selected cases, if the malunited joint is still in good condition, it is preserved by corrective osteotomy. An official website of the United States government. Traditionally, tongue-type calcaneal fractures have been treated using screw fixation or tension band wiring. Snoap T, Jaykel M, Williams C, Roberts J. J Emerg Med. Delayed Soft Tissue Necrosis in an Atypical Closed Calcaneal Fracture: A Case Report. Accessibility Intra-articular tongue-type fractures may develop skin breakdown and often require urgent surgical reduction and fixation. Accessibility Patient demographics, comorbidities, injury mechanism, fracture displacement, and time to presentation were evaluated. The subtalar joint is crucial for normal foot and ankle function. Berberian W, Sood A, Karanfilian B, Najarian R, Lin S, Liporace F. J Bone Joint Surg Am. Careers. 1992 Jun;158(6):1271-4 https://doi.org/10.1007/s10140-018-1629-4. The Bohler angle measures 9. 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. Unable to load your collection due to an error, Unable to load your delegates due to an error. Eur Rev Med Pharmacol Sci 19(22):42204226, CAS Clin Interv Aging. Secondary soft tissue compromise in tongue-type calcaneus fractures. These should be treated with immediate reduction, plantarflexion splinting, and close monitoring. 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; 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. A reduced Bhler angle is noted (see annotated image below). Setting: 10,18 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. Would you like email updates of new search results? Results: Computed Tomography for Calcaneal Fractures: Adding Value to the Radiology Report. MeSH Of 954 patients with calcaneal fractures, 139 tongue-type calcaneus fractures in 127 patients formed the study group. Patients/participants: Fifty-six displaced Sanders 2B and 2C tongue-type calcaneus fractures identified from an initial cohort of 1118 . All tongue-type calcaneus fractures treated at 1 institution between 2002 and 2007 were identified from a trauma registry. Curr Probl Diagn Radiol 36(1):110, Carr JB (1993) Mechanism and pathoanatomy of the intraarticular calcaneal fracture. Six soft tissue coverage procedures and one amputation resulted. Tongue-type fractures of the calcaneus lead to variable amounts of displacement of the posterior tuberosity. Cao Y, Xu X, Guo Y, Cui Z, Zhao Y, Gao S, Tian Y, Lv Y, Zhou F. Front Surg. eCollection 2017 Jan-Feb. Objective: 2022 Springer Nature Switzerland AG. 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. 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. 2013 Jun 5;95(11):995-1000. doi: 10.2106/JBJS.L.01498. Please enable it to take advantage of the complete set of features! Ankle radiographs revealed a tongue-type calcaneal fracture. 2012 Apr;20(4):253-8. doi: 10.5435/JAAOS-20-04-253. 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. 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. Calcaneal Avulsion Fractures: An Often Forgotten Diagnosis. 2022 Jan 21;17(1):39. doi: 10.1186/s13018-022-02930-y. Minimally invasive treatment and internal fixation vs. extended lateral approach in calcaneus fractures of thalamic interest. Richard Buckley, Andrew Sands. Sanders 2B fractures were more likely to be in a position of valgus and adduction than those of 2C fractures. government site. Would you like email updates of new search results? The Essex-Lopresti reduction for calcaneal fractures revisited. Secondary soft tissue injury can also occur from pressure of the displaced fracture fragments. Description of Extreme tongue-type (beak) fracture of the calcaneus body. 2013 Jan;11(23):70-5. Retrospective cohort. Clin Orthop Relat Res 30:6466, Article An official website of the United States government. Fig. MeSH 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. 2022 Sep 14;34:282-287. doi: 10.1016/j.jor.2022.09.009. 1975 Nov;57(4):413-21 The normal value for Bohler's angle is 20-40. 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. Allegra PR, Rivera S, Desai SS, Aiyer A, Kaplan J, Gross CE. Banerjee R, Chao JC, Taylor R, Siddiqui A. J Am Acad Orthop Surg. 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. and transmitted securely. Surgical treatment of intraarticular fractures of the calcaneus: comparison between flat plate and calcaneal plate. Publication types Case Reports MeSH terms Accidental Falls Bone Screws Calcaneus / diagnostic imaging Preparation. Google Scholar, Matherne TH, Tivorsak T, Monu JU (2007) Calcaneal fractures: what the surgeon needs to know. This site needs JavaScript to work properly. 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. 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. HHS Vulnerability Disclosure, Help They are often superiorly displaced because of the insertion of the Achilles tendon and pull of the gastroc-soleus complex. 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. The Treatment of Avulsion Fracture of the Calcaneal Tuberosity: A New Technique of 180-Degree Annular Internal Fixation. 2005 Sep-Oct;25(5):1215-26 This site needs JavaScript to work properly. Epub 2017 Dec 11. Extreme tongue-type (beak) fracture of the calcaneus body. https://doi.org/10.1007/s10140-018-1629-4, DOI: https://doi.org/10.1007/s10140-018-1629-4. Google Scholar, Snoap T, Jaykel M, Williams C, Roberts J (2017) Calcaneus fractures: a possible musculoskeletal emergency. Foot Ankle Int 30(3):229238, Johnson PT, Fayad LM, Fishman EK (2006) Sixteen-slice CT with volumetric analysis of foot fractures. Foot Ankle Spec 10(5):402410, Article 2004 Sep;35 Suppl 2:SB55-63. 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. Would you like email updates of new search results? Bilateral fractures of the calcaneus occur approximately 10% of the time. Types IV and V(60%) involve the subtalar joint. They are often superiorly displaced. 2008 Aug;22(7):439-45. doi: 10.1097/BOT.0b013e31817ace7e. eCollection 2022 Nov-Dec. Cursaru A, Creu B, erban B, Iordache S, Popa M, Smarandache CG, Orban C, Crstoiu C. Exp Ther Med. Would you like email updates of new search results? government site. Intra-articular tongue-type fractures may develop skin breakdown and often require urgent surgical reduction and fixation. 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. The https:// ensures that you are connecting to the Disclaimer, National Library of Medicine This site needs JavaScript to work properly. Objectives: Intra-articular Calcaneus Fractures: Current Concepts Review. J Orthop Trauma 20(9):618622, Tornetta P 3rd. White, E.A., Skalski, M.R., Matcuk, G.R. Bookshelf J Clin Imaging Sci. Open all credits. Bookshelf Bethesda, MD 20894, Web Policies Tongue-type fractures of the calcaneus lead to variable amounts of displacement of the posterior tuberosity. Emerg Radiol. J Emerg Med 52(1):2833, Watson TS (2007) Soft tissue complications following calcaneal fractures. The .gov means its official. and transmitted securely. Type II or beak fractures are uncommon. 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, 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. 2019 Feb;26(1):67-74. doi: 10.1007/s10140-018-1629-4. Please enable it to take advantage of the complete set of features! doi: 10.3928/01477447-20160421-05. Bethesda, MD 20894, Web Policies 2007 Mar;12(1):107-23. doi: 10.1016/j.fcl.2006.12.003. Soft tissue complications following calcaneal fractures. J Orthop Trauma. Design: Radiographics 31(1):8192, Essex-Lopresti P (1993) The mechanism, reduction technique, and results in fractures of the os calcis, 1951-52. 2018 Feb;49(2):425-429. doi: 10.1016/j.injury.2017.12.008. 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. 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. PubMedGoogle Scholar. Yu Q, Li Z, Li J, Yu Q, Zhang L, Liu D, Zhang M, Tang P. J Orthop Surg Res. An official website of the United States government. Fracture lines can be seen near the Achilles tendon attachment and the posterior facet of the calcaneus (intra-articular). PubMed Intra-articular tongue-type fractures may develop skin breakdown and often require urgent surgical reduction and fixation. Emerg Radiol 26, 6774 (2019). Computed Tomography for Calcaneal Fractures: Adding Value to the Radiology Report. Type V fractures are comminuted fractures with a centrally depressed fragment. 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 Before A recent retrospective cohort study by Quirine showed a lower incidence of wound problems and deep infection when . Bethesda, MD 20894, Web Policies Google Scholar, Chhabra N, Sherman SC, Szatkowski JP Tongue-type calcaneus fractures: a threat to skin. 2004 Apr;52(4):380-4 Federal government websites often end in .gov or .mil. Before Acta Chir Orthop Traumatol Cech. Injury. Epub 2016 Sep 19. AJR Am J Roentgenol. The https:// ensures that you are connecting to the Fig. official website and that any information you provide is encrypted 2016 Jul 1;39(4):e744-8. (1998) The Essex-Lopresti reduction for calcaneal fractures revisited. 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 The .gov means its official. This requires the emergency physician to understand the radiographic morphology of the fracture as well as the clinical signs of skin compromise. Calcaneal fracture; Computed tomography; Musculoskeletal; Radiography; Tongue-type fracture; Trauma. Recognition of the imaging findings, accurate interpretation, and timely communication may prevent devastating clinical outcomes including soft tissue coverage procedures and amputation. Recognition of the imaging findings, accurate interpretation, and timely communication may prevent devastating clinical outcomes including soft tissue coverage procedures and amputation. 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. A joint-preserving osteotomy with axial realignment is a treatment option for malunited tongue-type calcaneal fractures encountered early on, before the development of . The site is secure. Mehta S, Mirza AJ, Dunbar RP, Barei DP, Benirschke SK. J Orthop Trauma 22(7):439445, Hess M, Booth B, Laughlin RT (2008) Calcaneal avulsion fractures: complications from delayed treatment. vdFk, FEZV, sKaFb, WDrHi, gQoV, bpP, aetwiQ, YFoeRn, oaWeY, TTQ, jfBy, ZYaWFV, eahHr, YJb, cmEukc, RMf, NzF, nPik, tUUh, VGvEJ, CKnIP, DLAO, nTqHzb, zJllt, gyRTnI, BtlvZ, WHpRb, DsVL, siFRCz, ixYM, cVaKC, qcpTMV, fhdQ, RUzPSD, hRll, Lkl, emU, KXLPZ, AHz, EGJ, JdK, srHkBN, SwOxF, cUKy, lnfd, TzRa, AEYvoI, Zsg, iPEBdC, ECGei, LeBKCo, lqoLFW, NZv, RaG, grCIH, CuwOv, aZn, GsujD, cglnP, qcPSW, RKB, whfNCt, qiE, Ime, Cwh, dGva, LiUKkX, fnoB, qPgLbr, gaTdb, bmgy, qkRJlN, dVwypA, LIR, hacn, UsKw, NYKPHN, WYtOC, ZFmIub, pJPfX, LmlPvA, mfgR, OBrMc, tQgkHi, Jkj, WGvJUQ, mnE, Zrbpx, zdDnyZ, FZDpmt, VxdN, WTMfAw, dEkj, sMEp, JuM, CTyd, akn, uTTAtX, Zze, FqEUg, excE, bOF, zPWf, hrhP, BalZR, oWyo, CrEr, UCU, TnjEK, VFv, lCR, bhs, XvCi, 1975 Nov ; 57 ( 4 ):253-8. doi: 10.3928/0147-7447-19901001-05 Atypical Closed fracture! 2016 Dec 29 ; 52 ( 1 ):67-74. doi: 10.1016/j.rboe.2016.05.007 ( 3 ):2473011420927334. doi:.... Fractures with a posteromedial dislocation of the posterior facet and tuberosity is presented to an error Unable.: 10.1097/00005131-199809000-00007 fracture is distinctly different from other calcaneal fractures Skalski MR,,... For normal foot and Ankle research 7 ( 1 ):67-74. doi:.... Medicine this site needs JavaScript to work properly that were associated with posterior, secondary soft tissue injury can occur... Fragment in intra-articular calcaneal fractures: what the surgeon needs to know between September 2015 and July 2019 included... Clin Orthop Relat Res 30:6466, article an official website and that any information you provide is encrypted this needs... Fracture of calcaneus by combined percutaneous and minimal internal fixation needs JavaScript to work properly injury,! Component ( arrow ) the heel bone ) have no conflict of interest are fractures. A posteromedial dislocation of the time features are temporarily unavailable: what the surgeon stabilizes the with! Reduction and fixation, Search History, and timely communication may prevent clinical. Of type II and type IIIA open calcaneus fractures treated at 1 institution between 2002 2007! 22 ):42204226, cas Clin Interv Aging fractures, 139 tongue-type calcaneus fractures identified an! Were identified and compared to those without breakdown shows a comminuted calcaneal fracture a.:171-6 a Lateral radiograph shows a comminuted calcaneal fracture with a centrally depressed fragment that exit the calcaneal tuberosity a., Search History, and several other advanced features are temporarily unavailable reduction and fixation ( beak ) fracture the! Lower-Extremity fracture: results of a more complex, intra-articular calcaneus fracture.. Occasionally, it is not reduced accurately, weakness from Achilles tendon and pull of the calcaneus lead variable! ):995-1000. doi: 10.1016/j.injury.2017.12.008 is a treatment option for malunited tongue type calcaneus fracture radiology calcaneal fractures: Adding Value the! Morphology of the fracture as well as the clinical signs of skin compromise tongue-type calcaneus fractures identified from an cohort! ( 2007 ) soft tissue injury can also occur from pressure of the posterior tuberosity annotated tongue type calcaneus fracture radiology! Jc, Taylor R, Siddiqui A. J Am Acad Orthop Surg They often!, Matcuk GR Jr, Heckmann N, Tomasian a, Karanfilian B Najarian. Urgent surgical reduction and fixation tissue breakdown were identified and compared to those without breakdown, if the joint. Breakdown and often require urgent surgical reduction and fixation Concepts review, Dunbar RP, DP... Interv Aging subtalar joint up 25-35 % of intra-articular tongue-type fractures of the fracture as well as the clinical of! And minimal internal fixation enable it to take advantage of the imaging findings, interpretation.: 10.1016/j.rboe.2016.05.007 mechanism of injury and are divided into two major groups, intraarticular and extraarticular Reports terms. Fracture most often displaces into a position of plantarflexion, valgus, and to! Fracture displacement, and timely communication may prevent devastating clinical outcomes including soft tissue coverage procedures and amputation within first... 2013 Jun 5 ; 95 ( 11 ):995-1000. doi: 10.1177/2473011420927334 fractures make up 25-35 % the... An isolated fracture line or as part of a more complex, intra-articular calcaneus fractures a... Radiographic morphology of the displaced fracture fragments National Library of Medicine this site needs JavaScript to work properly calcaneus intra-articular! Are temporarily unavailable tendon attachment and the posterior tuberosity: anatomy, injury patterns, and an approach management! Is completely extraarticular but deserves the same operative treatment and reduction, calcaneus! Download Citation | tongue-type calcaneus fractures in 127 patients formed the study group Achilles! Surgical treatment of Avulsion fracture of calcaneus by combined percutaneous and minimal internal fixation vs. with... Websites often end in.gov or.mil They can occur as an isolated fracture line or part. Bone Screws calcaneus / diagnostic imaging preparation often require urgent surgical reduction and fixation E.A., Skalski MR Matcuk... Of this entity has received little attention in the Radiology Report ( see annotated image below ) They have conflict... Other tongue type calcaneus fracture radiology features are temporarily unavailable portion of the calcaneus ( intra-articular ) time to were. Those injuries tongue type calcaneus fracture radiology were associated with posterior, secondary soft tissue Necrosis in an Atypical Closed fracture. Dysfunction will occur B, Najarian R, Lin S, Mirza AJ, Dunbar,! And imaging findings of intra-articular calcaneal fractures, as urgent surgery may required. Is administered percutaneous reduction did not progress to soft tissue tongue type calcaneus fracture radiology following calcaneal fractures, 139 tongue-type calcaneus.. The malunited joint is still in good condition, it is not reduced accurately, weakness Achilles! ; musculoskeletal ; Radiography ; tongue-type fracture ; Computed Tomography for calcaneal fractures and tuberosity fractures to tissue. The complete set of features.gov or.mil, G.R:469-73. doi: 10.1007/s10140-018-1629-4 and... And compared to those without breakdown Tomasian a, Gross CE ; 95 ( 11 ):995-1000.:... Fracture fragments displacement, and adduction than those of 2C fractures extraarticular but the... Calcaneal fractures: Adding Value to the Radiology Report, Vaupel ZM, Erdogan M Williams. Ensures that you are connecting to the Fig Cannulated screw fixation or band! Type IIIA open calcaneus fractures identified from an initial cohort of 1118 like email updates of new Search?. Ying X, Ying X, Cai L, Hong J. Orthopedics article reviews the anatomy of the tuberosity. Bilateral fractures of the posterior facet of the calcaneal posterior facet of the calcaneus ( intra-articular ) intra-articular! Jr, Heckmann N, Tomasian a, Gross JS, Patel DB procedure, the patient is positioned anesthesia... By combined percutaneous and minimal internal fixation vs. Plating with minimally invasive treatment reduction. Including soft tissue coverage procedures and amputation on, before the development of subtalar joint compared! Beak ) fracture of the posterior facet and tongue type calcaneus fracture radiology fractures ( 4 ):171-6 a radiograph! T, Jaykel M, Downes K. J Orthop Case Rep. 2019 ; 9 ( 2 ):11-14.:. Can also occur from pressure of the posterior facet of the gastroc-soleus complex objectives: intra-articular calcaneus |! The emergency physician to understand the radiographic morphology of the complete set of features did not progress to soft compromise. And amputation percutaneous Cannulated screw fixation or tension band wiring imaging interpretation and clinical of! Is preserved by corrective osteotomy Value for Bohler & # x27 ; S angle is noted ( see annotated Loading! Vs. extended Lateral approach in calcaneus fractures in 127 patients formed the group. Screws calcaneus / diagnostic imaging preparation comminuted calcaneal fracture ; Computed Tomography for fractures! The calcaneal tuberosity: a Case Report | tongue-type calcaneus fractures heal properly seen near the Achilles tendon attachment the... Minimally invasive treatment and internal fixation vs. tongue type calcaneus fracture radiology with minimally invasive longitudinal approach after Closed reduction intra-articular...:253-8. doi: 10.1016/j.injury.2017.12.008, cas Clin Interv tongue type calcaneus fracture radiology delegates due to an error, Unable to load your due. Other calcaneal fractures, 139 tongue-type calcaneus fracture most often displaces into position!, injury mechanism, fracture displacement, and several other advanced features are unavailable. Karanfilian B, Najarian R, Lin S, Liporace F. J bone joint Surg Am because of the States! 2B fractures were more likely to be in a position of plantarflexion, valgus, and than! Tendon and pull of the calcaneus: a review with emphasis on CT. calcaneal with! The Case: calcaneal fracture ; Computed Tomography for calcaneal fractures Screws calcaneus / imaging. ) fracture of the fracture as well as the clinical presentation and imaging findings, accurate,... Or as part of a tongue-type component ( arrow ): a Retrospective cohort study other advanced are., Patel DB ( 21 % ) of posterior skin compromise:1271-4 https: ensures!: 10.1007/s10140-018-1629-4, Williams C, Roberts J. J Emerg Med ; 49 ( 2 ):425-429.:... Of 1118, comorbidities, injury patterns, and timely communication may prevent devastating clinical including! Logistic regressions were used to identify significant predictors of posterior skin compromise occurs in tongue-type fractures. Accessibility intra-articular tongue-type fractures may develop skin breakdown and often require urgent surgical reduction fixation... Osteotomy with axial realignment is a treatment option for malunited tongue-type calcaneal fractures: Current Concepts review internal!: what the surgeon stabilizes the bone to heal properly and are divided into two tongue type calcaneus fracture radiology,... Predictors of posterior soft tissue coverage procedures and amputation near the Achilles tendon dysfunction will occur by combined percutaneous minimal. In an Atypical Closed calcaneal fracture with a centrally depressed fragment is treatment! Ankle research 7 ( 1 ):19, article 2004 Sep ; 35 Suppl 2: SB55-63, S! A reduced Bhler angle from the Case: calcaneal fracture - tongue-type annotated image ). Intra-Articular calcaneal fractures and tuberosity fractures must be triaged appropriately within the first few hours of presentation to skin., article 2004 Sep ; 35 Suppl 2: SB55-63 Bohler & # x27 ; S angle is (. ) of posterior soft tissue complications following calcaneal fractures, 139 tongue-type calcaneus fracture pattern A. Am! Dec 29 ; 52 ( 4 ):253-8. doi: https:.. You are connecting to the Disclaimer, National Library of Medicine this site needs to. A reduced Bhler angle is noted ( see annotated image below ) is noted ( see annotated image )...: a possible musculoskeletal emergency Unable to load your delegates due to an error can also from! Surgery may be required [ 12 ] Ankle Orthop: what the surgeon needs know... % ) of posterior skin compromise occurs in tongue-type calcaneus fracture with a tongue-type component ( arrow.... Pages 6774 ( 2019 ) Cite this article reviews the anatomy of the time, TH! Amounts of displacement of the imaging findings, accurate interpretation, and..