Fig. 12.61.3
Semicoronal reconstruction of an axial CT scan of a calcaneus fracture. This scan has been taken at the level of the lateral malleolus and posterior facet of subtalar joint. The posterior facet is disrupted into two main fragments with a primary fracture line in the middle of the posterior facet (a Sanders 2b fracture). The fractured lateral wall is comprised of the body fragment inferiorly and the lateral joint fragment superiorly (an Atkins type 2 fracture).
1. Lateral malleolus.2. Body of talus.3. Medial malleolus.4. Sustentacular fragment and sustentaculum tali. Note that the fragment is rotated so that its inferior tip comes to lie more medial and that the tip of the sustentaculum is relatively undisplaced.5. Lateral joint fragment and the lateral part of the posterior facet.6. The lateral wall of the calcaneus which is pushed outwards and upwards broadening the heel and impinging on the lateral malleolus and the peroneal tendons.7. The tuberosity of the calcaneus and the body fragment. The fragment is tipped into varus bringing the heel-strike point medially. The body fragment is also pushed upwards so that its superomedial corner moves up the medial oblique face of the sustentacular fragment and so causes the body fragment to move laterally. This broadens that heel.8. The peroneal tendons which are closely applied to the displaced lateral wall.
