Extra-articular Fractures

 

Essex-Lopresti Classification

 

A.  Extra-Articular  (25%) 

 

Anterior Process fracture

Posterior Tuberosity avulsion

Medial & lateral Tuberosity

Sustentaculum Tali

Extra-articular body fractures

 

1.  Anterior process

 

Part of complex sprain / easily missed

- non operative if small

- ORIF if large and displaced

 

2.  Tuberosity fractures

 

Need ORIF if displaced

- have T Achilles attached and can put skin under threat

- ORIF (usually closed reduction and screw)

 

Calcaneum Tuberosity Fracture

 

Tongue typeTongue type calcaneumSkin displaced tongue fracture

 

ORIF tongue type 1ORIF tongue type 2

 

3.  Body fractures

 

Non operative treatment

 

4.  Sustentacular fractures

 

Sustenaculum Fracture CT 1Sustenaculum Fracture CT 2

 

ORIF if displaced

- medial approach with buttress plate