Ankle and Foot 47 - Department of Radiology - University of ...

47 Ankle and Foot 2273 47
LPT
N
APC
A
B
LM
M-STJ
ST
C
D
E
CCJ
Figure 47-81. Calcaneal fracture in a 40-year-old who fell
from a 4-foot ladder, landing on the heel. A, Lateral
radiograph shows a calcaneal fracture. B, CT scan in the
sagittal plane shows where the lateral process of the talus
(LPT; black arrow) drove into the calcaneus, causing wide
separation of the posterior facet of the subtalar joint
(bidirectional arrow). Incidentally seen is a nonosseous tarsal
coalition (arrowheads) between the anterior process of the
calcaneus (APC) and the navicular (N). C, CT scan in the
coronal oblique plane through the posterior facet of the
subtalar joint demonstrates the typical inferomedial direction
of the fracture (dashed arrow). There are often laterally
displaced fragments (black arrow). Normally, none of the
calcaneus should be below the lateral malleolus (LM). D, CT
scan in the coronal oblique plane through the middle facet
(arrow) shows that in this patient the sustentaculum tali (ST)
is in one large piece and that the fracture does not extend
into the middle facet. E, Axial CT scan through the
calcaneocuboid joint (CCJ) shows involvement of this joint
(arrowhead).
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9/9/2008 5:35:19 PM