title: Calcaneal fractures in occupants involved in severe frontal motor vehicle crashes.
abstract: The calcaneous is the largest tarsal bone in the foot and plays an important role in walking and running. Motor vehicle crashes and falls from elevation have been associated with calcaneal fractures. Although not life-threatening, these injuries may result in permanent disability. This study used the Crash Injury Research and Engineering Network (CIREN) database to describe calcaneal fractures and concomitant lower extremity skeletal injury patterns for occupants involved in motor vehicle crashes. Sixty-three drivers and 7 front row passengers with calcaneal fractures were identified in the CIREN database during 1997-2005. Almost all these occupants were involved in severe (based on the delta V and vehicle crush) frontal or off-set frontal crashes with toe pan intrusion. Eighty-four percent of the calcaneal fractures were intra-articular or partially articular. Overall, 93% of occupants also had injury to other body regions with 84% having other lower extremity fractures. One year after the crash, most occupants had not returned to their prior level of physical functioning. Surgically managing patients with calcaneal fractures for an optimal outcome remains a challenge for orthopedic surgeons. Because lower extremity injuries, including calcaneal fractures, may cause permanent disability, it is important to prevent these injuries through structural improvements in motor vehicle design.
authors.affiliation: Orthopedic Trauma and Fracture Specialists, San Diego, CA, United States.
authors.forename: Emily
authors.initials: E
authors.lastname: Benson
authors.forename: Carol
authors.initials: C
authors.lastname: Conroy
authors.forename: David B
authors.initials: DB
authors.lastname: Hoyt
authors.forename: A Brent
authors.initials: AB
authors.lastname: Eastman
authors.forename: Sharon
authors.initials: S
authors.lastname: Pacyna
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Smith
authors.forename: Frank
authors.initials: F
authors.lastname: Kennedy
authors.forename: Tom
authors.initials: T
authors.lastname: Velky
authors.forename: Michael
authors.initials: M
authors.lastname: Sise
mesh_terms: D015998:Abbreviated Injury Scale; D000063:Accidents, Traffic / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017278:Air Bags; D002111:Calcaneus / Q000293:injuries*; D005260:Female; D050723:Fractures, Bone / Q000150:complications / Q000453:epidemiology / Q000209:etiology* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D012042:Registries; D012622:Seat Belts; D014481:United States / Q000453:epidemiology