- 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;
- hence, the coronal fracture occurs posterior to the tuberosity;
- includes:
- sustenacular fragment: - contains medial aspect of posterior articlar fragment
- tounge fragment: contains tuberosity & lateral aspect of posterior articular fragment
- inferior portion of body of the calcaneus;
- fragmenation of the lateral wall is often mild;
- comminution anterior to the Angle of Gissane will often be severe;
- tongue fracture fragment will include portion of achilles tendon;
- Treatment:
- with displacement of tongue fragment there will be excessive tension on the posterior skin which can lead to necrosis;
-
Pathoantomy of intra-articular articular fractures of the calcaneus. A. Miric Md and Brendan M. Patterson MD. JBJS Vol 80-A. No 2. Feb 1988.
The Essex-Lopresti reduction for calcaneal fractures revisited
Secondary soft tissue compromise in tongue-type calcaneus fractures
Late sequelae of secondary Haglund's deformity after malunion of tongue type calcaneal fracture: report of two cases.
Congruity of the subtalar joint in tongue fracture of the calcaneus: an anatomical study.
