Talus and Calcaneum
The calcaneum and the talus are the most commonly fractured bone in the ankle and foot and are almost always high velocity injuries, and approximately 15% percent of them have bleeding wounds associated. It is most commonly injured following a fall from height, whereby there is significant axial loading directly onto the bone. These injuries can be associated with concurrent injuries to spine hence examination of back is very important.
Clinical features
Patients will typically present following recent trauma, such as a fall from height or road traffic accident with pain and tenderness around the heel region, with an inability to weight bear. On examination, the region will be significantly swollen and bruised, with potential for a shortened and widened heel. There can be an apparent deformity. It is important to asses for posterior heel skin integrity, as any tenting or blanched skin will warrant emergency surgical intervention.
Calcaneum fractures fixed with wires
Management
Conservative management with a plaster can be used for undisplaced calcaneum / talus fracture. Surgical management in the form of pin fixation/ screw fixation are advised to align the bones in a proper position.
OUTCOME
