Fractures of the Calcaneus

Courtesy: Prof Nabil Ebraheim, University of Toledo, Ohio, USA
It could be open or closed. Open fractures can be a big problem. Mechanism of injury is that the Primary fracture line is caused by an axial load injury. Primary fracture line goes from anterolateral to posteromedial,it divides the calcaneum into 2 main fragments. Superomedial fragment is a costant fragment ,called the sustentacular fragment and the Superolateral fragment called tuberosity fragment. Superomedial fragment includes the sustentaculum tali and it is stabilized to talus by ligaments. Talus is attached to constant fragment. Sustentacular fragment is a useful reference point for fracture reduction . Flexor hallucis longus tendon lies underneath the sustentaculum and if screw placement to the sustentacular fragment is too long,this could affect the flexor hallucis longus tendon,causing fixed flexion of the big toe