Sarah M. Yu, Abstract Co-Author: Nothing to Disclose

Joseph Sekiguchi Yu MD, Presenter: Nothing to Disclose

1. To identify the vulnerable areas in the calcaneus that is susceptible to avulsion fractures. 2. To differentiate avulsion fractures from other fractures that affect the calcaneus. 3. To discuss imaging strategies and algorithms that facilitates diagnosis.  

The calcaneus is the primary weightbearing bone in the heel. The morphology of this bone is complex and many of its surfaces serve as attachments to tendons, muscles, and ligaments.  Radiographic imaging is difficult.  The four articulating surfaces are oriented in different directions and the stabilizing ligaments that hold the calcenus in place occupy very specific locations.  Avulsion fractures vary in size as well as in their mechanisms of injury.  A proper search strategy allows recognition of these fractures and differentiation from normal variants in the foot. Contents: 1. NORMAL OSSEOUS ANATOMY 2. NORMAL SOFT TISSUE ANATOMY 3. TYPES OF CALCANEAL AVULSION FRACTURES 4. SITES OF VULNERABILITY a. Achilles tendon-calcaneal tuberosity b. Plantar fascia-middle calcaneal process c. Bifurcate ligament-anterior calcaneal process d. Extensor digitorum brevis-lateral cortex e. Calcaneocuboid ligament-cuboid articulating surface 5. PITFALLS a. Achilles tendon ossification b. Accessory ossicles c. Direct fractures          

http://abstract.rsna.org/uploads/2014/14005196/14005196_53dh.pdf

Yu, S, Yu, J, Calcaneal Avulsion Fractures: Anatomy, Nuances, Mechanisms, and Pitfalls.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14005196.html