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Entries in Orthopaedics (3)


Calcaneal Injuries (with a chocolatey twist)

The calcaneus is one of the thicker bones in the body. To fracture it takes a lot of force. The main mechanism that causes this fracture is a fall from a significant height, which delivers an axial load that can travel up the body and cause significant associated injuries.

Associated Injuries

  • Vertebral fractures – cervical, thoracic, lumbar. In particular crush fractures of the thoraco-lumbar spine
  • Other lower limb fractures: tibia, fibula, femur
  • Pelvic and acetabular fractures
  • Fracture of the contralateral calcaneum (always check both feet!)
  • Compartment syndrome of the foot
  • Fracture blisters (blistering of the skin due to oedema/swelling – can lead to soft tissue infection/osteomyelitis)
  • Soft tissue injury – ligamentous instability

Diagnostic Challenges

Conventional X-ray will diagnose most calcaneal fractures, however you must maintain a high index of suspicion in anyone with a suggestive history, who is unable to bear weight on their heel.  A “normal” x-ray does not exclude a calcaneal fracture, and CT will often reveal occult fractures.

Head on over to ETMCourse site for full post

Click to read more ...


Anatomy of Emergency Medicine, LisFranc Injuries

Andy at Emergency Medicine Ireland has just put out another great anatomy video in his dulcet Irish tones, continuing on the lower limb theme, this time focusing on the foot, and LisFranc injuries. Head over to Emergency Medicine Ireland now and check out the full post.

Emergency Medicine Ireland, Anatomy of Emergency Medicine, LisFranc Injuries 


Did Hell Just Freeze Over?

Oh dear oh dear. How did I miss this one? Thanks to Danny Ben-Eli for sending me this absolute gem from the BMJ this month. 

The orthopods have finally had enough. After generations of being made fun of for being at the less intelligent end of the medical spectrum (mainly by their anaesthetic colleagues), Subramanian et al from the UK have conducted a multicentre prospective comparative study, pitting male orthopaedic surgeons against male anaesthetists in a tests of grip strength, and intelligence. The results were somewhat unexpected...



To compare the intelligence and grip strength of orthopaedic surgeons and anaesthetists.


Multicentre prospective comparative study.


Three UK district general hospitals in 2011.


36 male orthopaedic surgeons and 40 male anaesthetists at consultant or specialist registrar grade.


Intelligence test score and dominant hand grip strength.


Orthopaedic surgeons had a statistically significantly greater mean grip strength (47.25 (SD 6.95) kg) than anaesthetists (43.83 (7.57) kg). The mean intelligence test score of orthopaedic surgeons was also statistically significantly greater at 105.19 (10.85) compared with 98.38 (14.45) for anaesthetists.


Male orthopaedic surgeons have greater intelligence and grip strength than their male anaesthetic colleagues, who should find new ways to make fun of their orthopaedic friends.

BMJ. 2011 Dec 15;343:d7506. doi: 10.1136/bmj.d7506.

Full Article