Davos Courses

Executive Editor: Joseph Schatzker

Authors: Richard Buckley, Andrew Sands

Calcaneus - Extreme tongue-type (beak) fractures

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Glossary

General considerations

This fracture compromises the soft tissue immediately surrounding the achilles tendon and may result in skin necrosis. Immediate fracture reduction and urgent surgical management can prevent this devastating complication. Usually these are simple fractures of the tongue type. Joy stick reduction is commonly used.

ORIF - screw fixation
Main indication Skill Equipment
Early (less than 24h) reduction in bony injury that compromises the skin surrounding the achilles tendon. Some specialized surgical experience Simple surgical and imaging resources

Indications

  • Soft tissue compromise of back of foot
  • Severe displacement of tongue type fracture

Advantages

  • Preservation of soft tissues at back of foot
  • Simple small incision surgery
  • No need for extensive soft tissue reconstruction
*Skill
Basic surgical experience, no specialized skills Basic surgical experience, no specialized skills
Some specialized surgical experience Some specialized surgical experience
Highly experienced and skilled surgeon Highly experienced and skilled surgeon
*Equipment
Basic equipment only Basic equipment only
Simple surgical and imaging resources Simple surgical and imaging resources
Full specialized surgical and imaging resources Full specialized surgical and imaging resources

v1.0 2010-10-14