scholarly journals Duckbill Calcaneum fracture

2021 ◽  
Vol 7 ◽  
Author(s):  
Najib Alidrissi
Keyword(s):  
Achilles Tendon ◽  
Swimming Pool ◽  
Tension Force ◽  
Cast Immobilization ◽  
Avulsion Fractures ◽  
Direct Trauma ◽  
Calcaneal Tuberosity

Introduction: The avulsion fractures of the calcaneal tuberosity represent a rare model of injury that is caused by a powerful tension force of the Achilles tendon associated or not to direct shock to the calcaneusCase report: We report a case of direct trauma to the heel on the edge of the swimming pool at the sport stroke of swimming.Percutaneous reduction by bone reduction forceps under fluoroscopy fluoroscopy with osteosynthesis by two percutaneous cannula screws on Kirchner wires. Equine cast immobilization after removal of the threads. Good clinical and functional radiological evolution.Conclusion: The percutaneous screw under fluoroscopy is the best technique with good results anatomical and functional and aesthetic.

The Heel of Achilles: Calcaneal Avulsion Fracture from a Gunshot Wound

Foot & Ankle ◽  
1989 ◽  
Vol 9 (4) ◽  
pp. 204-206 ◽  
Author(s):  
Daniel E. Cooper ◽  
James D. Heckman
Keyword(s):  
Achilles Tendon ◽  
Gunshot Wound ◽  
Achilles Tendon Rupture ◽  
Penetrating Trauma ◽  
Triceps Surae ◽  
Greek Mythology ◽  
Calcaneal Fractures ◽  
Avulsion Fractures ◽  
Simultaneous Extension ◽  
Calcaneal Tuberosity

Greek mythology relates that the legendary warrior Achilles was made invincible by his mother Thetis, who dipped him in the River Styx while holding him by his heel. Because his heel was never immersed, it remained his one area of vulnerability. After the fall of Troy, Achilles met his demise when he was shot in the heel by Paris, whose arrow was guided by the Greek god Apollo. This is the derivation of the term “Achilles tendon.” Avulsion fractures of the tuberosity of the calcaneus are rare injuries. 1 , 2 , 3 , 6 , 7 , 12 Schonbauer 14 reviewed a series of 870,000 accident cases treated at the Vienna Trauma Hospital and found only four such cases in addition to 151 cases of subcutaneous Achilles tendon rupture. In Bohler's 4 series of 182 calcaneal fractures, avulsion of the calcaneal tuberosity accounted for less than 1% of these injuries. Rowe 13 reported four Achilles avulsion fractures in his series of 154 calcaneal fractures. Three basic mechanisms of injury have been described: (1) dorsiflexion violence against the maximally plantarflexed foot, typically occurring in a fall from a height; (2) powerful contraction of the triceps surae muscle with simultaneous extension of the knee such as when a person is about to sprint in a race; (3) a direct blunt blow to the hindfoot. 1 , 2 , 8 We are describing a case of avulsion of the calcaneal tuberosity due to direct penetrating trauma from a gunshot wound, a mechanism not previously reported.

scholarly journals Novel Techniques in Treating Calcaneal Tuberosity Fractures

2014 ◽  
Vol 4 (1) ◽  
pp. 3-7
Author(s):  
Selene G Parekh ◽  
Todd Bertrand ◽  
Robert Zura ◽  
Samuel Adams ◽  
Alan Yan
Keyword(s):  
Internal Fixation ◽  
Achilles Tendon ◽  
Open Reduction ◽  
Tendon Transfer ◽  
Flexor Hallucis Longus ◽  
Suture Anchors ◽  
Calcaneal Fractures ◽  
Longus Tendon ◽  
K Wires ◽  
Calcaneal Tuberosity

ABSTRACT Calcaneal tuberosity fractures comprise only 1 to 2% of all calcaneal fractures. Treatment of these injuries has traditionally included open reduction and internal fixation with various means including lag screws, suture anchors and K-wires. We report on a series of cases treated with excision of the tuberosity fragment with repair of the Achilles tendon supplemented by a flexor hallucis longus tendon transfer. Parekh S, Bertrand T, Zura R, Adams S, Yan A. Novel Techniques in Treating Calcaneal Tuberosity Fractures. The Duke Orthop J 2014;4(1):3-7.

scholarly journals Endoscopic treatment of Achilles tendon enthesopathies: An anatomical and clinical feasibility study

2020 ◽  
Vol 8 (2_suppl) ◽  
pp. 2325967120S0000
Author(s):  
Olivier Boniface ◽  
Thomas Vervoort
Keyword(s):  
Achilles Tendon ◽  
Feasibility Study ◽  
Open Surgery ◽  
Wound Complications ◽  
Operating Technique ◽  
Clinical Series ◽  
Open Reconstruction ◽  
Tendon Insertion ◽  
Calcaneal Tuberosity

Background: One possible treatment for Achilles tendon enthesopathy is open reconstruction of the Achilles tendon insertion by resection of calcified enthesis and the calcaneal tuberosity followed by reinsertion of the tendon with anchors. Subcutaneous dissection of the tendon in open procedure is at risk of wound complications. We hypothesized that this procedure could be performed under endoscopy. Methods: An innovative operating technique was described. It consisted in removal and reinsertion of the Achilles tendon under endoscopy using five portals with resection of the calcaneal tuberosity and calcified enthesis. A feasibility study was first conducted on five cadaveric feet followed by an in vivo study on five patients. Results: In all cases, the Achilles tendon could be reinserted with the same technique than in open surgery. None of the ten surgical procedures technically failed. It was possible to correctly resect calcifications and the calcaneal tuberosity. Resection was performed under endoscopic and fluoroscopic control for the ten cases. Proper reinsertion was verified under endoscopy, by placement of the ankle in physiological equinus for clinical series and by dissection for cadaveric cases. There were no complications in the clinical series 3 months postoperatively. Conclusion: Achilles enthesopathies can be treated by detachment/reinsertion of the Achilles tendon under endoscopy with resection of calcified enthesis and the calcaneal tuberosity. This endoscopic technique should now be validated by analyzing longer-term clinical and anatomical results and comparing them with the results of open surgery.

scholarly journals Calcaneoplasty coupled with an insertional Achilles tendon reattachment procedure for the prevention of secondary calcaneal impingement: a retrospective study

2020 ◽  
Vol 11 ◽  
pp. 204062232094479
Author(s):  
Yanbin Pi ◽  
Yuelin Hu ◽  
Qinwei Guo ◽  
Dong Jiang ◽  
Xin Xie ◽  
...  
Keyword(s):  
Achilles Tendon ◽  
Achilles Tendon Rupture ◽  
Pain Scale ◽  
Mri Findings ◽  
Aofas Score ◽  
Foot Function ◽  
Magnetic Resonance Imaging Mri ◽  
Pain Symptoms ◽  
Tegner Score ◽  
Calcaneal Tuberosity

Background: Posterior heel pain may occur after an Achilles insertional rupture reattachment procedure and could be attributed to an impingement between the calcaneal tuberosity and Achilles tendon, which could be observed using postoperative magnetic resonance imaging (MRI). Moreover, such impingement, which may be associated with postoperative pain symptoms, could be relieved by calcaneoplasty. Methods: Postoperative Visual Analog Pain Scale (VAS), American Orthopedic Foot and Ankle Society (AOFAS) score, Foot Function Index (FFI), Ankle Activity Score (AAS), and Tegner score were obtained and compared between 10 patients who underwent calcaneoplasty (calcaneoplasty group) and 11 patients who did not receive calcaneoplasty (non-calcaneoplasty group). Several signs of calcaneal tuberosity impingement identified in MRI were also compared between the two groups, which included retrocalcaneal bursitis, postoperative tendinopathy, tendon calcification, bone marrow edema, increased Achilles tendon diameter, and bony spurs. Results: The VAS score was 2.00 ± 1.41 and 2.18 ± 1.83 ( p = 0.803), the AOFAS score was 90.60 ± 4.22 and 81.82 ± 7.77 ( p = 0.005), the FFI was 5.00 ± 2.86 and 17.18 ± 15.92 ( p = 0.028), the AAS was 5.50 ± 2.55 and 5.82 ± 2.04 ( p = 0.750), and the Tegner score was 4.30 ± 1.49 and 4.45 ± 1.21 ( p = 0.797) in the calcaneoplasty and non-calcaneoplasty groups, respectively. The AOFAS score and FFI were significantly different between the groups. MRI findings revealed that the non-calcaneoplasty group had significant signs of calcaneal impingement compared with the calcaneoplasty group. Conclusions: Secondary calcaneal impingement due to insertional tendon enlargement may occur, and prophylactic calcaneoplasty coupled with an insertional reattachment procedure could achieve promising postoperative outcomes for patients with insertional Achilles tendon rupture.

scholarly journals Cadaveric Anatomical Study of Sural Nerve: Where is The Safe Area for Endoscopic Gastrocnemius Recession?

2017 ◽  
Vol 11 (1) ◽  
pp. 1094-1098 ◽  
Author(s):  
Alvin Chin Kwong Tan ◽  
Zhi Hao Tang ◽  
Muhammad Farhan Bin Mohd Fadil
Keyword(s):  
Achilles Tendon ◽  
Sural Nerve ◽  
Anatomical Study ◽  
Lower Limbs ◽  
Lateral Border ◽  
Safe Area ◽  
Gastrocnemius Recession ◽  
The Mean ◽  
Tendon Insertion ◽  
Calcaneal Tuberosity

Purpose: To ascertain in cadavers where the sural nerve crosses the gastro-soleus complex and where the gastrocnemius tendon merges with the Achilles tendon in relation to the calcaneal tuberosities. Methods: Twelve cadaveric lower limbs (6 right and 6 left) were dissected. The distances between the calcaneal tuberosities and the lateral border of the Achilles tendon where the sural nerve crosses from medial to lateral, as well as to the gastrocnemius tendon insertion into the Achilles tendon, were measured. Results: The mean and median longitudinal distances from the calcaneal tuberosity to where the sural nerve crosses the lateral border of the Achilles tendon are 9.9cm and 10cm respectively (range 7cm to 14cm). The mean and median longitudinal distances from the calcaneal tuberosity to where the gastrocnemius tendon inserts into the Achilles tendon are 19.9cm and 18.5cm (range 17cm to 25cm) respectively. Conclusion: It is generally safe to place the posterolateral incision more than 14cm above the calcaneal tuberosity to avoid the sural nerve if surgeons plan to use a posterolateral incision for endoscopic recession. The distance between the calcaneal tuberosity to the gastrocnemius tendon insertion into the Achilles tendon is too highly variable to be used as a landmark for locating the gastrocnemius insertion.

scholarly journals Achilles tendon rupture in camel (Camelus dromedarius): Radiographic and Ultrasonographic findings

2019 ◽  
Keyword(s):  
Achilles Tendon ◽  
Tendon Rupture ◽  
Soft Tissues ◽  
Weight Bearing ◽  
Achilles Tendon Rupture ◽  
Clinical Decision ◽  
Heterogeneous Structure ◽  
Dromedary Camels ◽  
Fracture Of The Calcaneus ◽  
Calcaneal Tuberosity

This study describes the clinical presentation of Achilles tendon rupture and evaluates the utility of radiography and ultrasonography in the diagnosis of such disorder in dromedary camels. Seventeen camels were included in this study based on the clinical, radiographic and ultrasonographic evidence of Achilles tendon rupture. The clinical, radiographic and sonographic findings of studied camels differ according to the type, duration, and location of the tendon rupture. Complete and incomplete rupture of the Achilles tendon was precisely diagnosed in five (29.4%) and twelve (70.6%) camels respectively; ruptured deep and superficial parts of the Achilles tendon were recorded in 10 (58.8%) and 2 (11.8%) camels respectively. Clinically, the camels exhibited an acute non-weight-bearing lameness (second to fourth-grade lameness), with swelling in the tendon near the calcaneus. Radiographs revealed swelling of the soft tissues surrounding the Achilles tendon just proximal to the calcaneal tuberosity in most of the camels with the presence of avulsion fracture of the calcaneus in few cases (n=2). Ultrasonographically, the ruptured part was precisely diagnosed as swollen, oedematous, heterogeneous structure with the presence of anechoic or hypoechoic areas (core lesion). In conclusion, lateromedial radiographs and ultrasonography were helpful in diagnosis and differential diagnosis of different types of Achilles tendon rupture and subsequent clinical decision and surgical interference in dromedary camels.

scholarly journals Achilles tendon rupture in camel (Camelus dromedarius): Radiographic and Ultrasonographic findings

2019 ◽  
Keyword(s):  
Achilles Tendon ◽  
Tendon Rupture ◽  
Soft Tissues ◽  
Weight Bearing ◽  
Achilles Tendon Rupture ◽  
Clinical Decision ◽  
Heterogeneous Structure ◽  
Dromedary Camels ◽  
Fracture Of The Calcaneus ◽  
Calcaneal Tuberosity

This study describes the clinical presentation of Achilles tendon rupture and evaluates the utility of radiography and ultrasonography in the diagnosis of such disorder in dromedary camels. Seventeen camels were included in this study based on the clinical, radiographic and ultrasonographic evidence of Achilles tendon rupture. The clinical, radiographic and sonographic findings of studied camels differ according to the type, duration, and location of the tendon rupture. Complete and incomplete rupture of the Achilles tendon was precisely diagnosed in five (29.4%) and twelve (70.6%) camels respectively; ruptured deep and superficial parts of the Achilles tendon were recorded in 10 (58.8%) and 2 (11.8%) camels respectively. Clinically, the camels exhibited an acute non-weight-bearing lameness (second to fourth-grade lameness), with swelling in the tendon near the calcaneus. Radiographs revealed swelling of the soft tissues surrounding the Achilles tendon just proximal to the calcaneal tuberosity in most of the camels with the presence of avulsion fracture of the calcaneus in few cases (n=2). Ultrasonographically, the ruptured part was precisely diagnosed as swollen, oedematous, heterogeneous structure with the presence of anechoic or hypoechoic areas (core lesion). In conclusion, lateromedial radiographs and ultrasonography were helpful in diagnosis and differential diagnosis of different types of Achilles tendon rupture and subsequent clinical decision and surgical interference in dromedary camels.

scholarly journals Achilles tendon rupture in camel (Camelus dromedarius): Radiographic and Ultrasonographic findings

2019 ◽  
Keyword(s):  
Achilles Tendon ◽  
Tendon Rupture ◽  
Soft Tissues ◽  
Weight Bearing ◽  
Achilles Tendon Rupture ◽  
Clinical Decision ◽  
Heterogeneous Structure ◽  
Dromedary Camels ◽  
Fracture Of The Calcaneus ◽  
Calcaneal Tuberosity

This study describes the clinical presentation of Achilles tendon rupture and evaluates the utility of radiography and ultrasonography in the diagnosis of such disorder in dromedary camels. Seventeen camels were included in this study based on the clinical, radiographic and ultrasonographic evidence of Achilles tendon rupture. The clinical, radiographic and sonographic findings of studied camels differ according to the type, duration, and location of the tendon rupture. Complete and incomplete rupture of the Achilles tendon was precisely diagnosed in five (29.4%) and twelve (70.6%) camels respectively; ruptured deep and superficial parts of the Achilles tendon were recorded in 10 (58.8%) and 2 (11.8%) camels respectively. Clinically, the camels exhibited an acute non-weight-bearing lameness (second to fourth-grade lameness), with swelling in the tendon near the calcaneus. Radiographs revealed swelling of the soft tissues surrounding the Achilles tendon just proximal to the calcaneal tuberosity in most of the camels with the presence of avulsion fracture of the calcaneus in few cases (n=2). Ultrasonographically, the ruptured part was precisely diagnosed as swollen, oedematous, heterogeneous structure with the presence of anechoic or hypoechoic areas (core lesion). In conclusion, lateromedial radiographs and ultrasonography were helpful in diagnosis and differential diagnosis of different types of Achilles tendon rupture and subsequent clinical decision and surgical interference in dromedary camels.

scholarly journals Achilles tendon rupture in camel (Camelus dromedarius): Radiographic and Ultrasonographic findings

2019 ◽  
Keyword(s):  
Achilles Tendon ◽  
Tendon Rupture ◽  
Soft Tissues ◽  
Weight Bearing ◽  
Achilles Tendon Rupture ◽  
Clinical Decision ◽  
Heterogeneous Structure ◽  
Dromedary Camels ◽  
Fracture Of The Calcaneus ◽  
Calcaneal Tuberosity

This study describes the clinical presentation of Achilles tendon rupture and evaluates the utility of radiography and ultrasonography in the diagnosis of such disorder in dromedary camels. Seventeen camels were included in this study based on the clinical, radiographic and ultrasonographic evidence of Achilles tendon rupture. The clinical, radiographic and sonographic findings of studied camels differ according to the type, duration, and location of the tendon rupture. Complete and incomplete rupture of the Achilles tendon was precisely diagnosed in five (29.4%) and twelve (70.6%) camels respectively; ruptured deep and superficial parts of the Achilles tendon were recorded in 10 (58.8%) and 2 (11.8%) camels respectively. Clinically, the camels exhibited an acute non-weight-bearing lameness (second to fourth-grade lameness), with swelling in the tendon near the calcaneus. Radiographs revealed swelling of the soft tissues surrounding the Achilles tendon just proximal to the calcaneal tuberosity in most of the camels with the presence of avulsion fracture of the calcaneus in few cases (n=2). Ultrasonographically, the ruptured part was precisely diagnosed as swollen, oedematous, heterogeneous structure with the presence of anechoic or hypoechoic areas (core lesion). In conclusion, lateromedial radiographs and ultrasonography were helpful in diagnosis and differential diagnosis of different types of Achilles tendon rupture and subsequent clinical decision and surgical interference in dromedary camels.

Neuropathic Calcaneal Tuberosity Avulsion Fractures

1993 ◽  
Vol &NA; (296) ◽  
pp. 8???13 ◽  
Author(s):  
WILLIAM C. BIEHL ◽  
JAMES M. MORGAN ◽  
F. WILLIAM WAGNER ◽  
RODNEY GABRIEL
Keyword(s):  
Avulsion Fractures ◽  
Calcaneal Tuberosity
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