Calcaneal Fracture Classifications Flashcards

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Questions and Answers

What does the Rowe Classification primarily describe?

Fractures of the femur

Comminuted fractures

Intra-articular fractures (correct)

Extra-articular fractures (correct)

What is Rowe Type 1A?

Fracture of the medial or lateral calcaneal tubercle

What is Rowe Type 1B associated with?

Fracture of the sustentaculum tali

How does Rowe Type 1C occur?

Fracture of the anterior process Signup and view all the answers

Describe Rowe Type 2A fractures.

Fracture of the superior portion of the tuberosity (beak fracture of the tuberosity) Signup and view all the answers

What characterizes a Rowe Type 2B fracture?

Avulsion fracture of the tuberosity Signup and view all the answers

What type of fracture is Rowe Type 3?

Oblique body fracture without STJ involvement Signup and view all the answers

What does Rowe Type 4 refer to?

Fracture of the body that is intra-articular involving the STJ Signup and view all the answers

What is characteristic of a Rowe Type 5 fracture?

Intra-articular fracture with joint depression and comminution Signup and view all the answers

What does the Essex-Lopresti Classification involve?

Intra-articular calcaneal fractures Signup and view all the answers

Describe the Essex-Lopresti Tongue Type Fracture.

Primary shear fracture line separating the sustentaculum tali from the lateral body. Signup and view all the answers

What distinguishes the Essex-Lopresti Joint Depression Type Fracture?

Shear fracture that divides the calcaneus into two parts. Signup and view all the answers

What is the Sanders Classification used for?

CT classification of calcaneal fractures Signup and view all the answers

What defines Sanders Type 1?

All non-displaced intra-articular fractures Signup and view all the answers

What characterizes Sanders Type 2A?

Two-part fracture with a primary fracture line separating the lateral column from the central column. Signup and view all the answers

What is the primary feature of Sanders Type 2B fractures?

Two-part fracture with a primary fracture line separating the central column from the medial column. Signup and view all the answers

What is the feature of Sanders Type 2C?

Two-part fracture with a primary fracture line separating the medial column from the sustentaculum column. Signup and view all the answers

What does Sanders Type 3AB represent?

Three-part fracture with two fracture lines separating the posterior facet. Signup and view all the answers

Describe the Sanders Type 3AC fracture.

Three-part fracture with two fracture lines separating lateral and central/medial columns. Signup and view all the answers

What does Sanders Type 3BC denote?

Three-part fracture with two fracture lines separating lateral/central column, medial column, and sustentaculum column. Signup and view all the answers

What defines Sanders Type 4?

Four-part fracture with three fracture lines separating all columns of the posterior facet. Signup and view all the answers

Study Notes

Rowe Classification

Classifies calcaneal fractures, mainly focusing on extra-articular fractures but also includes some intra-articular aspects.

Rowe Type 1A

Involves fractures of the medial or lateral calcaneal tubercle.
Medial tubercle fractures result from falls with heel eversion; lateral tubercle fractures from heel inversion.
Lateral radiograph is the optimal imaging technique.
Treatment is contingent on the displacement and size of the fragment.

Rowe Type 1B

Characterized by fractures of the sustentaculum tali.
Typically occurs during a fall with twisting on a supinated foot.
Marks the initial stage of a joint depression fracture.
Painful range of motion in the flexor hallucis longus (FHL).
Best viewed with a calcaneal axial radiograph; treatment depends on displacement.

Rowe Type 1C

Occurs at the anterior process due to supination and plantarflexion.
This is the most common fracture type in this classification.
Best assessed with medial oblique and lateral radiographs; treatment relies on displacement.

Rowe Type 2A

Defined as a fracture of the superior portion of the tuberosity (beak fracture).
Generally results from direct trauma and spares the Achilles tendon insertion.
Lateral radiograph is preferred; treatment is determined by displacement.

Rowe Type 2B

An avulsion fracture of the tuberosity due to strong traction from the Achilles tendon.
This type involves the Achilles tendon.
Requires lateral radiograph for evaluation; surgical intervention is often favored because of tendon involvement.

Rowe Type 3

Represents an oblique body fracture without subtalar joint involvement.
Commonly arises from a fall with heel in varus or valgus position.
Considered the most frequent extra-articular fracture; treatment depends on displacement.

Rowe Type 4

A fracture of the body that is intra-articular and affects the subtalar joint.
Typically results from falls with the foot in plantarflexion.
Comparable to the Essex-Lopresti tongue type fracture; best visualized via CT scan.

Rowe Type 5

Identified as an intra-articular fracture with joint depression and comminution.
Occurs from falls with the foot in dorsiflexion.
Analogous to the Essex-Lopresti joint depression fracture; treated with open reduction and internal fixation (ORIF).

Essex-Lopresti Classification

Focuses on intra-articular calcaneal fractures.

Essex-Lopresti Tongue Type Fracture

Involves a primary shear fracture line that separates the sustentaculum tali from the lateral body of the calcaneus, resembling Rowe Type 1B.
Contains a secondary fracture line that exits through the back of the calcaneus, similar to Rowe Type 2A.

Essex-Lopresti Joint Depression Type Fracture

Shear fracture that divides the calcaneus into sustentaculum and tuberosity fragments.
The lateral portion of the posterior facet is isolated and impacted, leading to a decrease in height and increase in width of the calcaneus.

Sanders Classification

Classifies calcaneal fractures through CT imaging, dividing the calcaneus into four parts by three fracture lines (A, B, and C from lateral to medial).

Sanders Type 1

Encompasses all non-displaced intra-articular fractures regardless of the number of fracture lines.

Sanders Type 2A

Two-part fracture where the primary line is lateral, separating the lateral column from the central column.

Sanders Type 2B

Two-part fracture characterized by a primary fracture line in the center, separating the central column from the medial column.

Sanders Type 2C

A two-part fracture where the primary line is medial, separating the medial column from the sustentaculum column.

Sanders Type 3AB

Three-part fracture with two lines that divide the posterior facet into lateral, central, and medial columns.

Sanders Type 3AC

Three-part fracture with two lines separating the posterior facet into lateral column and central/medial column, including the sustentaculum.

Sanders Type 3BC

Another three-part fracture where the posterior facet is separated into lateral/central column, medial column, and sustentaculum column by two lines.

Sanders Type 4

A high comminuted four-part fracture characterized by three fracture lines separating all columns of the posterior facet and sustentaculum.
Typically involves more than four fragments, with joint depression present.

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Description

This quiz covers the various classifications of calcaneal fractures, focusing on the Rowe classification system. Each flashcard presents key definitions and characteristics of specific fracture types. It's an essential study tool for medical students and professionals interested in orthopedic injuries.