Avulsion Fractures of the Posterior Calcaneal Tuberosity (Beak Fracture). Functional and Radiographic Evaluation
Article Sidebar
Main Article Content
Abstract
Materials and Methods: The functional (AOFAS Score) and radiological outcomes of six patients were evaluated. Three patients were male and three were female (mean age: 35.6 years). The mean time interval between injury and admission to the operating room was 2.83 hours. The extensile lateral approach was used. The fracture was fixed with 3.5, 4.0, or 4.5mm cannulated and solid screws alone or in combination with 3.5 and 2.7mm locking plates.
Results: After a follow-up period of between 8 and 24 months, all the patients had clear signs of consolidation. On admission, all presented signs of soft tissue pain without signs of necrosis. The AOFAS score was 82.4 (5 good and 1 fair). The complications observed were a deep infection and loss of reductionin the same patient.
Conclusions: Beak fractures can generate soft tissue complications if they are not treated urgently due toinitial soft tissue involvement. Open reduction and fixation with screws and plates is the most stable fixation system.
Downloads
Metrics
Article Details
Manuscript acceptance by the Journal implies the simultaneous non-submission to any other journal or publishing house. The RAAOT is under the Licencia Creative Commnos Atribución-NoComercial-Compartir Obras Derivadas Igual 4.0 Internacional (CC-BY-NC.SA 4.0) (http://creativecommons.org/licences/by-nc-sa/4.0/deed.es). Articles can be shared, copied, distributed, modified, altered, transformed into a derivative work, executed and publicly communicated, provided a) the authors and the original publication (Journal, Publisher and URL) are mentioned, b) they are not used for commercial purposes, c) the same terms of the license are maintained.
In the event that the manuscript is approved for its next publication, the authors retain the copyright and will assign to the journal the rights of publication, edition, reproduction, distribution, exhibition and communication at a national and international level in the different databases. data, repositories and portals.
It is hereby stated that the mentioned manuscript has not been published and that it is not being printed in any other national or foreign journal.
The authors hereby accept the necessary modifications, suggested by the reviewers, in order to adapt the manuscript to the style and publication rules of this Journal.
References
review. Foot Ankle Int 2008;29(8):863-6. https://doi.org/10.3113/FAI.2008.0000
2. Hedlund LJ, Maki DD, Griffiths HJ. Calcaneus fractures in diabetic patients. J Diabetes Complications 1998;12:81-7. https://doi.org/10.1016/s1056-8727(97)00052-4
3. Swords M, Marsh R. Operative treatment of osteoporotic calcaneus fractures. Tech Foot Ankle Surg 2007;12(1):7-14. https://doi.org/10.1097/BTF.0b013e318031f44e
4. Lee SM, Huh SW, Chung JW, Kim DW, Kim YJ, Rhee SK. Avulsion fracture of the calcaneal tuberosity:
classification and its characteristics. Clin Orthop Surg 2012;4:134-8. https://doi.org/10.4055/cios.2012.4.2.134
5. Squires B, Allen PE, Livingstone J, Atkins RM. Fractures of the tuberosity of the calcaneus. J Bone Joint Surg Br
2001;83:55-61. https://doi.org/10.1302/0301-620x.83b1.11184
6. Hess M, Booth B, Laughlin RT. Calcaneal avulsion fractures: complications from delayed treatment. Am J Emerg
Med 2008;26(2):254. https://doi.org/10.1016/j.ajem.2007.04.033
7. Watson-Jones R. Fractures and joint injuries, 4th ed. Edinburgh: Churchill-Livingstone; 1955, vol. 2, p. 867.
8. Bohler L. The treatment of fractures, 4th ed. New York: Grune & Stratton; 1958, vol. 3, p. 2047.
9. Wiles P. Fractures, dislocations and sprains. London: J&A Churchill; 1960, p. 64.
10. Yu SM, Yu JS. Calcaneal avulsion fractures: an often forgotten diagnosis. AJR Am J Roentgenol 2015;205:1061-7. https://doi.org/10.2214/AJR.14.14190
11. Warrick CK, Bremner AE. Fractures of the calcaneum, with an atlas illustrating the various types of fracture. J Bone Joint Surg Br 1953;35:33-45. https://doi.org/10.1302/0301-620X.35B1.33
12. Robb CA, Davies MB. A new technique for fixation of calcaneal tuberosity avulsion fractures. Foot Ankle Surg
2003;9:221-4. https://doi.org/10.1016/S1268-7731(03)00089-4
13. Biehl WC 3rd, Morgan JM, Wagner FW Jr, Gabriel R. Neuropathic calcaneal tuberosity avulsion fractures. Clin
Orthop Relat Res 1993;296:8-13. PMID: 8222455
14. Banerjee R, Chao JC, Taylor R, Siddiqui A. Management of calcaneal tuberosity fractures. J Am Acad Orthop Surg 2012;20:253-8. https://doi.org/10.5435/JAAOS-20-04-253
15. Lowy M. Avulsion fractures of the calcaneus. J Bone Joint Surg Br 1969;51:494-7. PMID: 5820793
16. Khazen GE, Wilson AN, Ashfaq S, Parks BG, Schon LC. Fixation of calcaneal avulsion fractures using screws with and without suture anchors: a biomechanical investigation. Foot Ankle Int 2007;28:1183-6.
https://doi.org/10.3113/FAI.2007.1183
17. Miyamoto W, Takao M, Matsui K, Matsushita T. Fixation for avulsion fracture of the calcaneal tuberosity using a side-locking loop suture technique and anti-slip knot. Foot Ankle Int 2015,36:603-7. https://doi.org/10.1177/1071100714565179
18. Protheroe K. Avulsion fractures of the calcaneus. J Bone Joint Surg Br 1969;51:118-22. PMID: 5766349
19. Lui TH. Fixation of tendo Achilles avulsion fracture. Foot Ankle Surg 2009;15:58-61.
https://doi.org/10.1016/j.fas.2008.06.004