Association of calcaneal and spinal fractures

Abstract

Calcaneus fractures are common injuries that often lead to chronic pain and long-term disability. Appropriate initial management of calcaneal fractures involves assessment for concomitant trauma (polytrauma), and the vertebral column, in particular, the lumbar spine, is known to be especially vulnerable to simultaneous injury when the os calcis has been fractured. We undertook a retrospective cohort study that included 208 consecutive patients with data recorded in a radiographic database to determine the incidence of concomitant vertebral fracture in association with fracture of the calcaneus. A total of 15 calcaneal fractures (7.21%) were associated with concomitant vertebral fracture, and the lumbar spine was involved in 12 (80%) of these cases. The only clinical variable that was statistically significantly associated with the presence of concomitant calcaneal and vertebral fracture was localization of the vertebral fracture to the lumbar spine (p = .0001). The results of our investigation have indicated that the incidence of concomitant calcaneal and vertebral fractures was significantly lower clinically than the traditional 10% association described in previous studies.

Keywords: calcaneus; injury; lumbar spine; os calcis; polytrauma; vertebral fracture.