Concomitant spine and calcaneum fractures: a possible indication of less extensive injury.

STUDY DESIGN: Retrospective cohort study. OBJECTIVES: To study the incidence of concomitant calcaneum fractures in participants with traumatic spine fractures and to study the association of calcaneum injury with the mode of trauma, morphology and level of vertebral fracture and neurological status in participants with concomitant spine and calcaneum fracture. SETTING: Central Institute of Orthopaedics, Safdarjung Hospital, New Delhi, India. METHODS: Records of participants with traumatic spine fractures were analyzed. Participants who had calcaneum fracture confirmed on radiographs were considered to have concomitant spine and calcaneum fracture. In these participants, variables noted were age, gender, mode of trauma, level and morphology of vertebral fracture and neurological status. RESULTS: Concomitant calcaneum fracture was present in 43 participants out of a total of 358. The lumbar spine was involved in 72.09% of participants. 46.51% of participants had complete burst type of vertebral fractures. Neurology was found to be intact in 58.13% of participants. The association of concomitant calcaneum injury with the level of spine fracture and type of fracture were found to be statistically significant (p < 0.05). In particular, the association of concomitant calcaneal fracture with intact neurology and incomplete paraplegia (ASIA B, C or D) as compared to spinal injury cases without calcaneal fractures was statistically significant (p < 0.001). CONCLUSION: Calcaneum fractures co-exist with spine fractures in 12.01% participants. Concomitant calcaneal fracture(s) with spine trauma indicate a greater chance of incomplete injury or intact neurology possibly due to dispersion of force vectors.