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Twelve cases were classified as a joint depression type and six as tongue depression type.
Amongst the 16 patients, five were tongue type and 11 were joint depression types.
Much controversy remains regarding the treatment of isolated joint depression fractures.
For joint depression types, we used the approach described by Gallie in 1943 [5 ]
It is widely accepted that joint depression fractures with concomitant fractures of the surrounding metaphyseal struts must be treated operatively.
Therefore, greater manipulation of the tuberosity fragment was done in tongue depression type fractures than for the joint depression types.
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Open image in new window Fig. 1 A 30-year-old male with a joint depression-type fracture.
Conversely, if the force was behind the joint but across the body and out between the posterior facet and the level of the insertion of the tendo Achilles, then the more common joint depression-type fracture occurred.
One study of 28 patients with joint depression-type calcaneal fractures treated with a locking plate reported that 86% of patients had excellent-to-good results based on AOFAS scores, good functional outcomes and restoration of anatomy [42].
If this force continues even further, a secondary fracture line is created and depending on the direction of the force, a tongue-type fracture or joint depression-type fracture will form.
Many techniques in operative fixation have used the a Schanz pin to manipulate the tuberosity of the calcaneus in Sanders types II, III and joint depression-type fracture patterns to align it and ensure anatomical reduction [39, 40].
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