Restoration of calcaneal anatomy and physiologic function after fracture: the importance of tuber length
Abstract. Objectives:. To evaluate calcaneal tuber length (TL) and its influence on calcaneal height (CH), talar declination angle (TDA), and function during plantarflexion after operative fixation of calcaneus fractures. Design:. Retrospective case–control study. Setting:. Large, urban, level 1 tra...
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| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer
2025-09-01
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| Series: | OTA International |
| Online Access: | http://journals.lww.com/10.1097/OI9.0000000000000412 |
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| Summary: | Abstract. Objectives:. To evaluate calcaneal tuber length (TL) and its influence on calcaneal height (CH), talar declination angle (TDA), and function during plantarflexion after operative fixation of calcaneus fractures.
Design:. Retrospective case–control study.
Setting:. Large, urban, level 1 trauma center.
Patients/Participants:. A total of 39 patients from 2012 to 2022 with isolated intra-articular calcaneus fractures with weight-bearing lateral postoperative and contralateral x-rays (to use as internal control) with at least 1 year follow up.
Intervention:. Patients underwent fixation of calcaneus fractures and were separated into “short tuber” (ST) and “restored tuber” (RT) groups. Postoperative radiographs were compared with contralateral radiographs.
Main Outcome Measurements:. Calcaneal Bohler angle (BA), TL, CH, TDA, and relative work increase using the equation Work = Force × Distance. Fixation methods related to TL were also investigated.
Results:. Overall, 37 of 39 patients (95%) had postoperative BA within 20–40°. 8 of 39 patients were in the ST group, and 31 of 39 were in the RT group. The average TL difference was 0.73 cm in ST versus 0.13 cm in RT (P < 0.01). The average CH difference was 0.46 cm in ST versus 0.28 cm in RT (P = 0.04). The average TDA difference was 9.9° in ST (flatter) versus 2.6° in RT (P = 0.024). The average work increase to plantarflex the ankle was 12.1% in ST versus 2.2% in RT (P < 0.01). Open fixation resulted in shorter TLs compared with the contralateral side (P = 0.02), but percutaneous fixation did not (P = 0.17).
Conclusions:. Despite restoring BA, presence of a shortened tuber can still result in decreased CH and a flat talus compared with the contralateral limb. It also required increased work to plantarflex the ankle, further highlighting the importance of restoring tuber length.
Level of Evidence:. IV. |
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| ISSN: | 2574-2167 |