X-ray of calcaneal fractures

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Planning

Projectional radiography ("X-ray") is usually the initial modality for suspected calcaneal fracture.

Diagnosis

File:Gissane.jpg
Gissane's angle

On lateral radiographs:

  • The Angle of Gissane, also called "Critical Angle", is the angle formed by the downward and upward slopes of the calcaneal superior surface. An angle of Gissane of more than 130° suggests a fracture of the posterior subtalar joint surface.

Bohler's angle, or the "Tuber Angle" is formed by the intersection of

  • A line from the highest point of the posterior articular facet to the highest point of the posterior tuberosity.
  • A line tangential to the superior edge of the tuberosity.[1]

Bohler's angle is normally 25° to 40°.[1] A decreased angle is indicative of a calcaneal fracture.

Further evaluation

A CT scan of calcaneal fracture is currently the imaging study of choice for evaluating calcaneal injury.<[2]

References

  1. 1.0 1.1 1.2 Page 562 in: Mark D. Miller; Stephen R. Thompson (2015). Miller's Review of Orthopaedics (7th ed.). Elsevier Health Sciences. ISBN 9780323390422. 
  2. Badillo, Kenneth; Pacheco, Jose A.; Padua, Samuel O.; Gomez, Angel A.; Colon, Edgar; Vidal, Jorge A. (2011). "Multidetector CT Evaluation of Calcaneal Fractures ". RadioGraphics 31 (1): 81–92. doi:10.1148/rg.311105036. PMID 21257934.