| Objective To investigate the image characteristics of the intraarticular calcaneal fracture
combined with severe skin contusion. Methods From June 2001 to August 2010, 12 male patients with closed calcaneal nodule fractures combined with severe skin contusion, aged from 24 to 52 years old with a mean of 32 years old, were treated. The fractures included 5 cases in the left foot, 3 cases in the right foot, 4 cases with fall injury, 3 cases with sport injury, 1 case with other cause of injury, and 3 cases with diabetes. The time between injury and surgery was from 4h t0 17 days, with an average of 12 days. All patients were being taken front and lateral X-ray and calcaneal axial CT. According to Sander classification, there were 5 cases in type II and 3 cases in type III. One patient was performed lateral expansion of' routine incision. The remaining patients underwent local small incision, fracture reduction, and the use of 2 to 3 Steinmann pin fixation or hollow screw and absorbable screw fixation. One case was fixed with wire. Results The 12 patients were followed up for 9~20 months, with an average of 11 months. Postoperative skin and soft tissue necrosis occurred in 1 case, resulting in heel hone nodule exposure. It was recovered after delayed transplant with gastrocnemius flap. Injury of local soft tissue recovered well in the rest of the patients. The function of the achilles tendon recovered well. No postoperative wound infection and delayed healing occurred. Conclusion The imaging characteristics show that the fracture lines appear from anterior-superior to posterior-inferior on the lateral X-ray film, and associate with subtalar joint plate. The distal end of the fracture appears in open shape. These patients often combine with inside heel tubercle fracture. |