Diferencia entre revisiones de «Foot and toe fractures»
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==Talus== | ==Hindfoot== | ||
===Background=== | ===Talus=== | ||
====Background==== | |||
*Almost always associated with other injuries | *Almost always associated with other injuries | ||
===Diagnosis=== | ====Diagnosis==== | ||
*CT often required for accurate diagnosis | *CT often required for accurate diagnosis | ||
===Management=== | ====Management==== | ||
*Major fracture (talar neck and head) | *Major fracture (talar neck and head) | ||
**Immediate ortho consultation required (high rate of avascular necrosis) | **Immediate ortho consultation required (high rate of avascular necrosis) | ||
| Línea 12: | Línea 13: | ||
**Posterior splint, NWB, ortho referral | **Posterior splint, NWB, ortho referral | ||
==Calcaneus== | ===Calcaneus=== | ||
===Background=== | ====Background==== | ||
*Associated injuries are common | *Associated injuries are common | ||
*Types | *Types | ||
| Línea 21: | Línea 22: | ||
***Anterior process fx is most common | ***Anterior process fx is most common | ||
===Diagnosis=== | ====Diagnosis==== | ||
*Imaging | *Imaging | ||
**Decreased Boehler's angle (<25') may be only sign of fx (compare w/ opposite side) | **Decreased Boehler's angle (<25') may be only sign of fx (compare w/ opposite side) | ||
===Treatment=== | ====Treatment==== | ||
*Intra-articular fracture | *Intra-articular fracture | ||
**Immobilization w/ posterior splint | **Immobilization w/ posterior splint | ||
| Línea 34: | Línea 35: | ||
**Immobilization and close ortho f/u | **Immobilization and close ortho f/u | ||
===Images=== | ====Images==== | ||
*(A) Normal Boehler's angle and (B) Abnormal Boehler's angle | *(A) Normal Boehler's angle and (B) Abnormal Boehler's angle | ||
[[File:Boehler's_Angle.jpg]] | [[File:Boehler's_Angle.jpg]] | ||
==Midfoot== | |||
==Fifth Metatarsal== | ==Fifth Metatarsal== | ||
Revisión del 20:18 17 feb 2012
Hindfoot
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
Midfoot
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