bsangeor at u
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Feb 7, 2007, 7:37 AM
Post #2 of 2
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though the few slices af CT arent adequate to diagnose or plan treatement,
in general sustentacular fractures ( called "special type 2" injuries by
letournel) can be managed with 2 screws if unstable or closed if
stable.stress the calcaneus laterally with the patient asleep. If the calc
doesnt sublux from beneath the talus, treat it in a boot with early motion.
Though the fracture may go on to non union, the patient doesnt care.
If it does sublux, lag the two sections together from either medial or
lateral, depending upon what other injuries you are treating. good luck
bruce
ps; this does not fit the written description of a sanders 4 as the sanders
classification doesnt include fractures anterior to the posterior facet
Bruce Sangeorzan, MD
Professor Orthopedics and Sports Medicine University of Washington
Chief of Orthopedics, Harborview Medical Center
Patient Care 206 731-4830
Academic office 206 731-4631
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----- Original Message -----
From: "Charles Blitzer" <Charles@Blitzer.org>
To: <ORT-L@www2.aaos.org>
Sent: Tuesday, February 06, 2007 5:53 PM
Subject: [ORT-L] Sustentacular Fx
> Attached are images of 23 yo MVC w/ bilat calcaneal fx'x, bilat ankle fx'x
> R is displaced Sanders 4 calcaneus w/ unstable bimall fx.
> Images are L which has small Weber A fibula, minimal swelling and this
> sustentacular fx.
> I see very little info as to management of sustentacular fx and would
> appreciate thoughts on this injury.
> Thanks
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