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Radiographic Evaluation: Calcaneal Fractures

          


- See: X-rays of the Foot

- Radiographs:
    - broden's view:
    - dorsoplantar (AP):
             - delineates calcaneocuboid joint
             - demonstrates amount of lateral spread of calcaneus
             - demnstrates subluxation of talonavicular joint;
             - frx lines will extend into anterior body of calcaneus, deforming articulation, and severe displacement of calcaneal frx may be assoc w/ talonavicular subluxation;
    - lateral view:
             - decrease in Bohler's angle;
             - incongruity and loss of height of posterior facet;
             - increase in angle of Gissane;
             - demonstrates joint depression & tongue type frx;
             - lateral x-rays provide minimal information about subtalar joint;
             - direction of the primary fracture line is typically vertical where as secondary posterior fracture line is transversely oriented;
    - harris beath view - axial calcaneal projection
             - obtained by angling beam 45 (10 to 45 deg) from behind leg, & centering it on posterior portion of sub-talar joint;
             - demonstrates tuberosity, body, sustentaculotalar joint, & posterior facet of the calcaneus;
             - amount of widening of the heel
             - impingement of lateral frag on peroneal space & lateral malleolus;
             - degree of overiding of superomedial fragment on psoterolateral fragment, & degree of comminution & displacement of subtalar fracture fragments;
             - axial or tangential radiograph is helpful in assessing direction of primary frx line, involvement of posterior talocalcaneal joint, lateral comminution of frx, & spreading of the heel


- CT Scan for Calcaneal Fractures          



Radiologic aspects of calcaneal fractures in childhood and adolescence.

The radiologic evaluation of calcaneal fractures.