- Discussion:
- involves vertical loading of calcaneus by talus at crucial angle of Gissane;
- usually occurs from a fall from ht landing on heels;
- primary fracture line may take one of three paths:
- lateral to posterior facet (from impact on pronated foot)
- thru posterior facet (neutral foot position)
- secondary frx line will appear beneath facet, exiting posteriorly and resulting in a tounge type fracture;
- anteromedial to the posterior facet:
- from impact on supinated foot;
- primary saggital frx line enters calcaneal sulcus, anteriomedial to posterior facets, & entire posterior facet remains intact;
- secondary frx line:
- results from axial force;
- posterolateral aspect of talus impacts on posterior facet resulting in explosion of lateral wall that may extend as far laterally as the calcaneocuboid joint;
- if load is more horizontal, secondary frx line will exit just behind posteior facet which results in joint depression type of injury;
- resultant free lateral fragment of posterior facet separates from tuberosity fragment;
- this superolateral fragment is also known as semilunar fragment