Calcaneal fracture - tongue-type

Case contributed by Leonardo Lustosa

Presentation

Fall from a 2-meter height. Unable to bear weight on his left foot.

Patient Data

Age: 45 years
Gender: Male
x_ray

Ankle radiographs revealed a tongue-type calcaneal fracture. Fracture lines can be seen near the Achilles tendon attachment and the posterior facet of the calcaneus (intra-articular).

A reduced Böhler angle is noted (see annotated image below).

Böhler angle

Annotated image

Reduced Böhler angle is shown in red.

The Böhler angle is measured between a line drawn from the highest point of the anterior process of the calcaneus to the highest point of the posterior facet, and a line drawn tangential to the superior edge of the tuberosity and the posterior facet.

Case Discussion

Calcaneal fractures are usually caused by high-energy trauma, such as a fall from height.

The Böhler angle is measured between a line drawn from the highest point of the anterior process of the calcaneus to the highest point of the posterior facet, and a line drawn tangential to the superior edge of the tuberosity and the posterior facet. An angle less than 20º is suggestive of a calcaneal fracture.

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