Fig. 12.61.8
 Axial CT scan of a calcaneus fracture.

Axial CT scan of a calcaneus fracture.

1. The sustentaculum tali and sustentacular fragment. This scan shows more clearly than the coronal scan the size of the fragment but does not demonstrate displacement.2. The medial extension of the coronal secondary fracture line passing into the sustentaculum tali. This fracture line usually passes just anterior to the sustentaculum.3. The anterior part of the calcaneus is in one piece in this fracture and the calcaneocuboid joint is not involved. This fracture is therefore a Zwipp and Tscherne 4 part 2 joint fracture. The fracture fragments are sustentacular, lateral joint, body and anterior. The two involved joints are the posterior and middle facets of the sub-talar joint.4. The lateral joint fragment5. The posterior extension of the longitudinal secondary fracture line. Since this exits the posterior rather than the superior aspect of the bone, the fracture is an Essex–Lopresti tongue type.6. The posterior limit of the primary fracture line separating the sustentacular fragment antero-medially from the body fragment posterolaterally. The body fragment is displaced anteriorly compared to the sustentacular fragment.
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