Computed Tomographic Classification and Operative Treatment of Intraarticular Calcaneal Fractures

관절내 종골 골절의 전산화 단층촬영에 따른 분류 및 수술적 치료

Purpose: To propose a new comprehensive classification system of intraarticular calcaneal fracture based on CT images. Materials and methods: Fourty intraarticular calcaneal fractures which were treated operatively were evaluated retrospectively. We classified fracture types according to severity of comminution on the posterior facet and calcaneocuboid joint by CT images. And we evaluated postoperative results of each fracture types in terms of the quality of fixation and reduction by the postoperative plain radiograghs. Results: By the classification of the posterior facet, 18 cases were P-I, 15 were P-II, and 7 were P-III. Among the P-I cases, 7 were P-IA, 9 were P-IL, 1 was P-IM and 2 were P-IT. According to the classification of calcaneocuboid joint, II cases were C-I, 18 were C-II and 11 were C-III. Qualities of fixation were excellent in 27 cases (67.5%), fair in 9(22.5%) and poor in 4(10%). Qualities of reduction were excellent 23 cases(57.5%), fair in 11(27.5%) and poor in 6(15%). Conclusion: Our new classification system based on the CT images could provide informations about the fracture configuration and severity of comminution around calcaneocuboid joint as well as the posterior facet. And the high grade fractures such as type P-III are need to be taken care of fixation of articular surfaces.