Fractures of the Sustentaculum Tali
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Sustentaculum tali fractures are rare injuries seen following a fall onto a varus-placed hindfoot or as part of a constellation of peritalar fracture/dislocations. In isolation, these fractures are often missed or diagnosed late. Frequently, an axial (Harris) X-ray view of the calcaneus and/or computed tomography (CT) scan is needed for diagnosis. Operative intervention is recommended as the sustentaculum plays a key role in maintaining medial column architecture. Additionally, sustentaculum fractures often involve the middle facet of the calcaneus. As such, a fracture of the sustentaculum can cause incongruity of the middle facet and should be treated as an intra-articular fracture. The preferred approach for operative fixation is a medial longitudinal incision centered over the course of the posterior tibial tendon. The outcomes of operative intervention are limited to case reports and case series but demonstrate a preservation of function.
KeywordsCalcaneus Sustentaculum tali Fracture Constant fragment Hindfoot
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