Avulsion Fractures of Posterior Calcaneal Tuberosity: Identification of Prognostic Factors and Classification

Soto, Pablo Carnero-Martín de; Bautista-Enrique, David; Gómez-Cáceres, Abel; Rodríguez-León, Alfredo; Bravo-Zurita, María José; Santos-Maraver, M. T.

doi:10.1053/j.jfas.2018.09.002

Cited by 14 publications

(19 citation statements)

References 19 publications

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“…14 In a retrospective study of 21 posterior calcaneal tuberosity avulsion fractures, the complication rate was 61.9%, with secondary loss of reduction and soft-tissue complications (infection, skin necrosis, and wound dehiscence) being the most common. 20 This study demonstrated a significantly higher probability of developing complications with increased (≥2 cm) fracture displacement. 20 Neuropathic fractures have a much higher incidence of infection, nonunion, malunion, delayed union, and failure of fixation relative to nonneuropathic insufficiency fractures.…”

Section: Achilles Tendon Avulsion Fracturesmentioning

confidence: 59%

Beyond the Malleoli: Part 2—Avulsion Fractures of the Hindfoot

2023

Contemporary Diagnostic Radiology

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Avulsion fractures of the ankle and hindfoot are a diverse group of injuries occurring at level of retinacular, capsuloligamentous, and tendinous attachments. Accurate identification of avulsion fractures and their origins is based on understanding the relevant soft-tissue anatomy. In the first part of this two-series article, avulsion fractures at level of the ankle retinacula and distal tibiofibular syndesmosis were reviewed. The second part of this series of two articles is dedicated to reviewing the relevant anatomy, injury mechanisms, classification, nomenclature, imaging, treatment, and complications of hindfoot avulsion fractures occurring at level of the lateral ankle ligament complex (distally), posterior talar process, tendinous attachments, and miscellaneous softtissue attachments not otherwise specified.

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Section: Achilles Tendon Avulsion Fracturesmentioning

confidence: 59%

Beyond the Malleoli: Part 2—Avulsion Fractures of the Hindfoot

2023

Contemporary Diagnostic Radiology

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“…In a retrospective study of 21 posterior calcaneal tuberosity avulsion fractures, the complication rate was 61.9%, with secondary loss of reduction and soft-tissue complications (infection, skin necrosis, and wound dehiscence) being the most common 20. This study demonstrated a significantly higher probability of developing complications with increased (≥2 cm) fracture displacement 20. Neuropathic fractures have a much higher incidence of infection, nonunion, malunion, delayed union, and failure of fixation relative to nonneuropathic insufficiency fractures 17…”

Section: Avulsion Fractures At Level Of Tendon Attachmentsmentioning

confidence: 99%

Beyond the Malleoli: Part 2—Avulsion Fractures of the Hindfoot

Kani

Davis

et al. 2023

Contemporary Diagnostic Radiology

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“…Displaced posterior calcaneal tubercle fractures, especially Beavis type 2 "beak" fractures, can easily lead to local skin and soft tissue pressure necrosis and the formation of ulcers [17]. Skin blisters and deep abrasions play an important role in treatment decisions, a delay in treatment may lead to serious skin complications.…”

Section: Incision Selection and Soft Tissue Protectionmentioning

confidence: 99%

Calcaneal Tuberosity Fracture (Beak Fracture) Fixation Using a Pre-contoured “L-form” Hook Plate: A Retrospective Study

Zhang¹,

Chan

Wu³

2021

Preprint

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Background: The treatment of calcaneal tuberosity fracture (beak fracture) is very tricky. Patients’ ankle function may be badly affected by skin flap necrosis and internal fixation failure. This study presented a simple, and safe internal fixation technique which is to fix the fracture fragment with a pre-contoured “L-form” hook plate.Methods: A retrospective study was done to analyze patients with calcaneal tuberosity fracture who were treated with pre-contoured “L-form” hook plate fixation from January 2015 to February 2020. When the patients could complete single-legged heel raise tests, and when they achieved clinical healing criteria were reviewed. Functional assessment was performed according to the American Orthopaedic Foot and Ankle Society Ankle-Hindfoot (AOFAS-AH) scores and the Visual Analogue Scale (VAS) was recommended for assessment of pain intensity (PI).Results: There were a total of 15 patients of calcaneal tuberosity fracture (beak fracture) treated with the pre-contoured “L-form” hook plate fixation technique, among which eight patients were female and the others were male, with the age ranging from 35 to 69 years (average of 55.3±9.0 years). And the mean duration of follow-up was 22.53±5.78 months (range: 12 to 36 months). 11 cases underwent emergency surgery. After the operation, there were no complications such as wound dehiscence, poor wound healing, infections, or plate exposure, no sural nerve injuries or venous thromboembolic events. Also, there was no loss of reduction or fixation failure in the follow-up. All 15 cases achieved clinical healing at 8-13 weeks (average 10.5±1.4 weeks) postoperatively. They were able to perform the test on their affected leg after 3.7±0.7 months (3-5 months) on average. The preoperative VAS and AOFAS-AH scores were 5.7±0.6 and 24.0±9.9 respectively, while the postoperative VAS and AOFAS-AH scores at the last follow-up were 1.3±0.5 and 93.8±5.2 (p<0.001).Conclusion: Emergency open reduction and internal fixation should be provided as soon as possible. For patients with Beavis type II beak fractures, the pre-contoured “L-form” hook plate fixation technique helps them restore normal ankle function. This simple, safe, and strong internal fixation technique can be one of the treatment options for avulsion fractures of the calcaneal tuberosity.

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Avulsion Fractures of Posterior Calcaneal Tuberosity: Identification of Prognostic Factors and Classification

Cited by 14 publications

References 19 publications

Beyond the Malleoli: Part 2—Avulsion Fractures of the Hindfoot

Beyond the Malleoli: Part 2—Avulsion Fractures of the Hindfoot

Beyond the Malleoli: Part 2—Avulsion Fractures of the Hindfoot

Calcaneal Tuberosity Fracture (Beak Fracture) Fixation Using a Pre-contoured “L-form” Hook Plate: A Retrospective Study

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