Calcaneal fractures are among the most complex and challenging injuries in lower limb trauma, demanding a thorough understanding of hindfoot biomechanics and surgical decision-making. This in-depth orthopaedic masterclass covers everything from the Sanders CT classification to ORIF techniques and avoiding wound complications. ⏱ Chapters 0:00 Intro 0:25 Essentials 1:02 Sanders 1:41 Bohler 2:15 Smoke 2:45 Safe 3:15 Algorithm 3:51 Numbers 4:22 Clinical reasoning — Approach 4:53 Clinical reasoning — Surgery Managing calcaneal fractures requires precise evaluation of axial loading injuries, posterior facet displacementand crucial soft tissue considerations. This video provides a comprehensive breakdown of the injury mechanism, radiographic assessment using Bohler and Gissane anglesand the definitive Sanders classification system. We explore the critical steps for surgical planning, including when to pursue conservative care versus open reduction and internal fixation (ORIF), the nuances of the extensile lateral approachand the high-risk factors for wound dehiscence. 🦴 IN THIS VIDEO YOU'LL LEARN • How to accurately measure and interpret Bohler and Gissane angles on lateral radiographs • The precise methodology for assigning the Sanders CT classification in the coronal plane • The anatomical importance of the sustentaculum tali as a stable constant fragment • How to apply the SMOKE mnemonic to predict and mitigate wound complication risk factors • The surgical steps and neurovascular protection required for the extensile lateral approach using the SAFE mnemonic • The clinical criteria for diagnosing and treating foot compartment syndrome • Why surgical timing must wait for a positive wrinkle test and soft tissue resolution • The rationale for performing a primary subtalar fusion in older heavy labourers ⏱️ CHAPTERS 📌 KEY TAKEAWAYS ✔️ Always screen the lumbar spine when evaluating calcaneal fractures, as 10% are bilateral with a 25% concurrent spinal injury rate. ✔️ A Bohler angle of less than 20 degrees indicates significant posterior facet collapse and predicts poor outcomes without surgical intervention. ✔️ Wait 10 to 21 days for swelling to subside and a positive wrinkle test before proceeding with ORIF to minimise wound necrosis risks. ✔️ The sustentaculum tali remains attached to the talus and serves as the reliable medial reference point for fracture reduction. ✔️ Consider primary subtalar fusion for highly comminuted Sanders Type IV fractures, particularly in older heavy manual labourers. 👩⚕️ WHO THIS IS FOR This masterclass is essential viewing for orthopaedic trainees, medical studentsand clinicians seeking a comprehensive understanding of complex hindfoot trauma. Curious patients looking for an in-depth, educational perspective on calcaneal fracture management will also find valuable insights here. 📚 RELATED TOPICS: Extensile Lateral Approach Surgical Technique · Sinus Tarsi Approach for Calcaneal Fractures · Subtalar Arthritis and Arthrodesis · Foot Compartment Syndrome Diagnosis and Fasciotomy · Tongue-Type Calcaneal Fracture Management · Operative Versus Conservative Calcaneus Fracture Outcomes 🔗 More free orthopaedic teaching at Orthovellum.com — subscribe for weekly videos. 🎨 CREDITS • Original Orthovellum production. ⚠️ DISCLAIMER: Educational only — not individual medical advice. Always consult a qualified clinician for diagnosis and treatment. #orthopaedics #calcanealfracture #footandankle #orthopaedicsurgery #trauma #sandersclassification #fracturefixation #orif #bohlerangle #hindfoot #orthoteaching #medicaleducation