Majority of calcaneal fractures are a result of a fall from a height.
Most are intra-articular, which are more serious and disabling than intra-articular.
The area most commonly involved in calcaneal fractures is the posterior facet.
Presentation & Mechanism
Can be divided into 6 surfaces: supererior, inferior, medial, lateral, anterior, and posterior.
The calcaneus is composed of a shell of thin cortical bone. The inner cancellous bone displays a pattern which resembles the static and dynamic stresses placed on the bone.
Talar relationship to calcaneus
Mechanism of Injury
Plantar ecchymosis – hallmark of calcaneal fracture
Pain around heel
Mechanism of Fracture
Palmer – JBJS 1948
Peter Essex-Lopresti – BJS 1952
Extra articular – better prognosis
Intra articular – worse prognosis
Essex-Lopresti - X-ray based classification
Sander's - CT classification (coronal)
Lateral Radiograph - Most important
Axial Radiographs - 2nd Most important x-ray
DP View (AP view)
Open vs Closed Indications
Goal of Reconstruction
ORIF – McReynolds
ORIF – Palmer