Calcaneal Fractures Lovers Fracture Sustained after jumping from

Calcaneal Fractures “Lover’s Fracture” (Sustained after jumping from a window whilst fleeing a jealous lover’s partner)

Mechanism: Fall from height landing on the feet Symptoms: Pain on weight bearing (unsurprisingly) in the heels Signs: Swelling, tenderness, erythema surrounding heel. Also look a haematoma extending distally along sole of foot “Mondor sign”. Investigations: XR calcaneum (axial, oblique, lateral +/AP), if communited may need CT for surgical planning Treatment: If extrarticular/Sanders Type I* then conservative treatment (backslab, 2 -4 weeks NWB and # clinic f/u) If Sanders Type II-IV* will need ORIF or closed reduction and percutaneous fixation

*Sanders Classification of Intraarticular Calcaneal Fractures • Type I: Non displaced fracture • Type II: Single intrarticular fracture that divides calcaneum into two displaced pieces • Type III: Two intrarticular fractures which divide the calcaneum into three displaced pieces • Type IV: Fractures involving more than three intrarticular pieces

Bohler Angle • Angle formed at the crossing of lines drawn from the posterior and anterior aspects of the superior calcaneum on lateral radiographs. • Angle less than 20 degrees is seen in calcaneum fractures(but angle can also be normal in a fracture, normal range 20– 40 degrees).