Correlations between the Clinical Results and Radiologic Evaluation after Surgical Treatment of Calcaneal Fracture

종골 골절의 수술적 치료 후 방사선학적 평가와 임상적 결과의 상관 관계: 종골 골절의 술 후 방사선학적인 평가

  • Park, Hyun-Woo (Department of Orthopedic Surgery, Dankook University College of Medicine) ;
  • Kim, Yeon-Jun (Department of Orthopedic Surgery, Dankook University College of Medicine)
  • 박현우 (단국대학교 의과대학 정형외과학교실) ;
  • 김연준 (단국대학교 의과대학 정형외과학교실)
  • Received : 2010.10.24
  • Accepted : 2010.11.18
  • Published : 2010.12.15

Abstract

Purpose: The purpose of this study is to find out the correlation factors for prognosis of calcaneal fractures. Materials and Methods: 120 cases (feet) of calcaneal fractures, all of them followed up for more than 1 year after surgical procedures, consisted of 101 men (105 feet) and 13 women (15 feet) were reviewed retrospectively. The collected clinical data were as follows : injury mechanism, surgical procedures, time to procedure, time to work and the radiologic data: Bohler angle, heel width, displacement of posterior facet. AOFAS hindfoot score and VAS score were checked. With ANOVA test and multiple regression analysis, the data processed statistically. Results: According Sanders classification, type II was 37 cases (31%), type III 66 cases (55%), and type IV 17 cases (14%). On plane radiography, the Bohler angle improved to average 28.4 degree from 5.6 degree, and the displacement of posterior facet was corrected to average 1.2 mm. AOFAS hindfoot score was checked average 81.7 points postoperatively, and the meaningful difference existed between types of Sanders classification. The Bohler angle represented the outline of the calcaneus had the better correlation with the clinical outcome of calcaneal fractures rather than the anatomical reduction of the posterior facet did. And the width of calcaneus had good correlation with the clinical score. Conclusion: We should also concern about the outline of calcaneus, the width of calcaneus and the Bohler angle representing anatomical reduction, not only the acute reduction of the posterior facet.

Keywords

References

  1. Burns AE. Fractures of the calcaneus. Symposium on osseous trauma of the foot. Clin Podiatry. 1985;2:311-24.
  2. Fernandez DL, Koella C. Combined percutaneous and "minimal" internal fixation for displaced articular fractures of the calcaneus. Clin Orthop Relat Res.1993;290:108-16.
  3. Hart AJ, Eastwood DM. Displaced intra-articular fractures of the calcaneum: what is new? Trauma. 2003;5:9-21. https://doi.org/10.1191/1460408603ta259oa
  4. Loucks C, Buckley R. Bohler's angle: correlation with outcome in displaced intra-articular calcaneal fractures. J Orthop Trauma. 1999;13:554-8 . https://doi.org/10.1097/00005131-199911000-00007
  5. Ogawa BK, Charlton TP, Thordarson DB. Radiography versus computed tomography for displacement assessment in calcaneal fractures. Foot Ankle Int. 2009;30:1005-10. https://doi.org/10.3113/FAI.2009.1005
  6. Sanders R, Fortin P, Diapasquale T, Walling A. Operative treatment in 120 displaced calcaneal fractures: results using a prognostic computed tomography scan classification. Clin Orthop Relat Res. 1993;290:87-95 .
  7. Soeur R, Remy R. Fractures of the calcaneus with displacement of the thalamic portion. J Bone Joint Surg. 1975;57:413-21 .
  8. Whittaker AH. Treatment of fractures of the os calcis by open reduction and internal fixation. Am J Surg. 1947;74:687-96. https://doi.org/10.1016/0002-9610(47)90225-0
  9. Zwipp H, Tscherne H, Thermann H, Weber T. Osteosynthesis of displaced intraarticular fracturesof the calcaneus. Results in 123 cases. Clin Orthop Relat Res. 1993;290:76-86 .