title: Calcaneus Fractures: A Possible Musculoskeletal Emergency.
abstract: BACKGROUND
  Calcaneal fractures are commonly seen and treated in the emergency department. There are subsets of calcaneal fractures that pose a high risk to the adjacent soft tissue of the heel and can result in full-thickness tissue necrosis.
  
  
  OBJECTIVE
  To identify which calcaneal fractures need to be managed within hours and triaged to the orthopedic team and which can be temporized in a neutral or plantarflexed ankle splint and seen in an outpatient setting.
  
  
  CONCLUSIONS
  Tongue-type calcaneal fractures and tuberosity fractures must be triaged appropriately within the first few hours of presentation to prevent skin compromise. This requires the emergency physician to understand the radiographic morphology of the fracture as well as the clinical signs of skin compromise. Communication with the orthopedic surgery service is essential and splinting in a specific manner is important to stabilize the soft tissue envelope.
  
  
  CONCLUSIONS
  Recognizing the calcaneal injury pattern and implementing the correct treatment strategy is paramount to having successful patient outcomes. A delay or error in treatment can turn a closed fracture into an open fracture.
authors.affiliation: Department of Orthopaedics, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, Michigan.
authors.forename: Tyler
authors.initials: T
authors.lastname: Snoap
authors.affiliation: Department of Orthopaedics, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, Michigan.
authors.forename: Matthew
authors.initials: M
authors.lastname: Jaykel
authors.affiliation: Department of Emergency Medicine, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, Michigan.
authors.forename: Cayla
authors.initials: C
authors.lastname: Williams
authors.affiliation: Bronson Orthopedic Trauma, Kalamazoo, Michigan.
authors.forename: Jason
authors.initials: J
authors.lastname: Roberts
mesh_terms: D000328:Adult; D002111:Calcaneus / Q000000981:diagnostic imaging / Q000293:injuries*; D004636:Emergency Service, Hospital / Q000458:organization & administration; D005260:Female; D050723:Fractures, Bone / Q000145:classification* / Q000150:complications* / Q000534:rehabilitation; D005596:Fractures, Closed / Q000534:rehabilitation / Q000601:surgery / Q000628:therapy; D006801:Humans; D008297:Male; D009140:Musculoskeletal Diseases; D011859:Radiography / Q000379:methods
keywords: Essex-Lopresti; calcaneus fracture; splinting; tongue type