Transverse fractures of the shaft of the calcaneus require application of one or two narrow 4.5-mm plates or one broad plate placed on the plantarolateral aspect of the bone. Small fragments distant from the calcaneal bursa can be removed through a direct approach or left to heal conservatively if they are not infected, but larger fragments should be repaired by screw fixation using lag technique.
Skyline views are useful for evaluating the tuber calcis and sustentaculum tali.
In addition to standard projections, stressed radiographs can provide important information for diagnosis and management. Lameness is usually severe with calcaneus fractures, and diagnosis is straightforward. An open wound and local infection can eventually extend into the tarsal sheath. Major fractures of the calcaneus can result in displacement of the superficial flexor tendon or can involve the sustentaculum tali ( Figure 97-16). Auer, in Equine Surgery (Fourth Edition), 2012 CalcaneusĬalcaneal fractures are often open and can be complicated by osteomyelitis, septic calcaneal bursitis, sequestration, and chronic drainage. If a decision is made at that time to euthanize the patient, massive costs can be avoided. If signs of infection are present, the wound needs to be evaluated immediately and the owner should be informed of the complication and the potentially grave prognosis. Subsequently, a half-shell cast should be applied for an additional 3 weeks, followed by a Robert Jones dressing, provided the horse doesn’t show signs of infection at an earlier time. Aggressive treatment should be implemented as soon as possible after the injury has occurred and includes meticulous dèbridement of the wound, removal of the fragment, curettage of the fracture bed, lavage of the bursa, broad-spectrum antibiotics for 3 weeks, and placement of the limb in a cast for 3 weeks. Invariably the bursa gets infected, and eventually the patient has to be destroyed for humane reasons. 23,29,30įractures involving the calcaneal bursa in the presence of an open wound from a kick usually have a poor prognosis for future soundness.
Calcaneus fracture full#
Removal of the implants after fracture healing can be helpful, but the overall prognosis to return to full performance for this type of fracture is guarded. 18 The superficial digital flexor tendon is reflected medially to allow placement of the plate, and the horse is recovered and maintained for 2 to 4 weeks in a full-limb cast that is removed with the horse standing. Transverse fractures of the shaft of the calcaneus require application of one or two narrow 4.5-mm limited-contact dynamic compression plates (LC-DCPs) or one broad 4.5-mm LC-DCP to the plantarolateral aspect of the bone. Small fragments distant from the calcaneal bursa can be removed through a direct approach or left to heal conservatively if they are not infected, but larger fragments should be repaired by lag screw fixation.
In addition to standard projections, stressed radiographs can provide additional important information for diagnosis and management. Major fractures of the calcaneus can result in displacement of the superficial flexor tendon or can involve the sustentaculum tali. Auer, in Equine Surgery (Third Edition), 2006 CalcaneusĬalcaneal fractures are often open and can be complicated by osteomyelitis, septic calcaneal bursitis, sequestration, and chronic drainage.
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