J Korean Fract Soc.  2003 Oct;16(4):526-533.

Usefulness of CT Scan in Treatment of Calcaneal Fracture

• Kim HJ
• Ha KI
• Yoon JR
• Shim JI
• Kim TS
• Kim YB
• Lee WS
• Choi JH

Abstract

PURPOSE: Accurate fracture classification is difficult because of its complex bony architecture and there is no definitive treatment modality according to fracture pattern or classification. We evaluated the fracture pattern using simple radiography and CT scan simultaneously and then the result according to treatment modalities and fracture classification.
MATERIALS AND METHODS
We evaluated 24 patients (26 cases) who suffered intraarticular calcaneal fracture were treated with closed reduction and axial pinning or open reduction and plate fixation. There were had taken CT scan. Fractures were classified with two different manner using both plain radiography and CT scan. Essex-Lopresti classification was made with plain radiography and Sanders classification was made with CT scan. Radiographic results were measured of preoperative and postoperative Bohler angle on plain x-ray. 16 patients (17 cases) were analyzed for clinical outcomes by Salama's criteria focused on pain, patients' satisfaction, walking abilities and usage of orthosis.
RESULTS
Mean followed-up period was 6 years (range 1~8.8 years). 8 cases were classified into tongue type intraarticular calcaneal fractures by plain radiography and 9 cases into joint depression type. According to Sanders classification by CT scan, 5 cases were classified into type IIA, 1 case IIC, 4 cases type IIIA, 4 cases IIIB and 3 case type IV. 12 fractures were reduced by closed reduction and axial fixation and 5 cases by open reduction and internal fixation. There was no correlation between clinical outcomes and treatment modality but there was linear correlation between clinical outcomes and postoperative Bohler angle (correlation coefficient = 0.04). In 8 cases of tongue type by plain radiography, sanders type IIC was only 1 case which calcaneal tuberosity connected to articular facet but articular involvements were observed in remaining cases.
CONCLUSION
Accurate eavaluation of articular facet in calcaneal fracture by CT scan is necessary to determining to select the treatment option.

Keyword

Calcaneal fracture; Intraarticular fracture; CT scan

MeSH Terms

Classification
Depression
Humans
Intra-Articular Fractures
Joints
Orthotic Devices
Radiography
Tomography, X-Ray Computed*
Tongue
Walking