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http://dx.doi.org/10.14193/jkfas.2014.18.4.165

Correlation Analysis of Reduction for Intra-Articular Calcaneal Fracture and Clinical Outcomes Using Postoperative Computed Tomography  

Eom, Joon-Sang (Department of Orthopaedic Surgery, Konkuk University School of Medicine)
Joo, Young-Deuk (Department of Orthopaedic Surgery, Konkuk University School of Medicine)
Kim, Seong-Jun (The Armed Forces Yangju Hospital)
Shin, Min-Ho (LCT Hospital)
Lee, Dong-Oh (Department of Orthopaedic Surgery, Konkuk University School of Medicine)
Jung, Hong-Geun (Department of Orthopaedic Surgery, Konkuk University School of Medicine)
Publication Information
Journal of Korean Foot and Ankle Society / v.18, no.4, 2014 , pp. 165-172 More about this Journal
Abstract
Purpose: We evaluated the correlation of postoperative clinical outcomes and radiologic findings using computed tomography and simple X-ray in intra-articular calcaneal fractures. Materials and Methods: The current study is based on 41 feet, 38 patients with displaced intra-articular fracture who underwent surgical treatment with at least one year of follow-up. Evaluation of clinical outcome included American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, visual analogue scale (VAS) score, and subjective satisfaction. A simple X-ray was used in evaluation of preoperative and postoperative Gissane angle, B${\ddot{O}}$hler angle, and calcaneal fracture width. Computed tomography scan was performed for evaluation of preoperative and postoperative articular step-off and articular gap in all cases. Finally, we evaluated the correlation of the postoperative clinical outcomes and radiologic findings based on the measurement. Results: The average postoperative AOFAS score and VAS score was $84.1{\pm}8.5$ and $2.2{\pm}2.2$. Subjective satisfaction was excellent in 15 cases, good in 19 cases, and fair in seven cases. The average B${\ddot{O}}$hler angle was restored from $11.1^{\circ}$ to $24.7^{\circ}$(p<0.05), Gissane angle was changed from $121.0^{\circ}$ to $119.0^{\circ}$ (p>0.05), and the average width was restored from 45.8 to 35.0 mm (p<0.05). The average articular step-off and gap were decreased from 6.3 to 2.0 mm and from 11.1 to 4.6 mm, respectively (p<0.05). No significant correlations were observed between the clinical outcome and Gissane angle, B${\ddot{O}}$hler angle, and width, and there was no significant correlation between the clinical outcome and Sanders classification. However, postoperative articular step-off showed correlation with VAS and AOFAS score and articular gap showed correlation with VAS score. Conclusion: The clinical outcome did not show correlation with B${\ddot{O}}$hler angle and Gissane angle but did show correlation with anatomical reduction of the posterior facet joint.
Keywords
Calcaneal fracture; Articular step-off; Articular gap; Computed tomography;
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