Diferencia entre revisiones de «Foot and toe fractures»
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==Talus== | ==Talus== | ||
* | ===Background=== | ||
** | *Almost always associated with other injuries | ||
* | |||
** | ===Diagnosis=== | ||
*CT often required for accurate diagnosis | |||
===Management=== | |||
*Major fracture (talar neck and head) | |||
**Immediate ortho consultation required (high rate of avascular necrosis) | |||
*Minor fracture | |||
**Posterior splint, NWB, ortho referral | |||
==Calcaneus== | ==Calcaneus== | ||
Revisión del 20:14 17 feb 2012
Talus
Background
- Almost always associated with other injuries
Diagnosis
- CT often required for accurate diagnosis
Management
- Major fracture (talar neck and head)
- Immediate ortho consultation required (high rate of avascular necrosis)
- Minor fracture
- Posterior splint, NWB, ortho referral
Calcaneus
Background
- Associated injuries are common
- Types
- Intra-articular (75%)
- Sclerotic line may be only evidence of impacted fracture
- Extra-articular (25%)
- Anterior process fx is most common
- Intra-articular (75%)
Diagnosis
- Imaging
- Decreased Boehler's angle (<25') may be only sign of fx (compare w/ opposite side)
Treatment
- Intra-articular fracture
- Immobilization w/ posterior splint
- Non-weightbearing
- Elevation (very important - fx has high rate of severe swelling)
- Ortho consult
- Extra-articular fracture
- Immobilization and close ortho f/u
Images
- (A) Normal Boehler's angle and (B) Abnormal Boehler's angle
Fifth Metatarsal
Jones Fracture
- <1.5 cm from proximal tip of 5th metatarsal
- transverse
- ORIF
Dancer's (Avulsion) Fracture
- proximal tip of 5th metatarsal (more proximal than Jones)
- avulsion (spiral) fracture, frequently displaced
- inversion injury (common in ballet dancers)
- Do not confuse unfused apophysis with a fracture!
- treatment
- mildly displaced: heal w/ 6 to 8 weeks w/ short leg cast
- displaced frxs (3-5 mm): may require ORIF