• Journal of Korean Foot and Ankle Society
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• v.17 no.2
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• pp.79-83
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• 2013

Calcaneus is largest tarsal bone and the fracture of calcaneus is most common tarsal fractures. Calcaneal fractures are divided into extra-articular and intra-articular fractures. Intra-articular calcaneal fractures could be classified as tongue type and joint depression type using simple lateral radiograph (Essex-Lopresti classification), but Sanders suggested new classification according to involving the posterior facet of calcaneus using computed tomography. The involvement of posterior facet was revealed as more complicated than Essex-Lopresti classification. The principle purpose of treatment of calcaneal fractures are restoration of calcaneal height (B$\ddot{o}$hler angle), width, axis, anatomical reduction of joint and restoration of function through the stable fixation. Good visualization of joint and anatomical reduction could be achieved by extended lateral approach. But, skin problem could be occurred after of extended lateral approach.

• Journal of Korean Foot and Ankle Society
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• v.11 no.1
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• pp.79-85
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• 2007

Purpose: To evaluate the clinical efficacy of the limited posterior approach for the surgical treatment of intraarticular fracture of calcaneus. Materials and Methods: From March 2000 to February 2006, we studied retrospectively 186 patients, 203 cases who were treated with open reduction and internal fixation through limited posterior approach and were followed up for more than 1 year. The clinical results were evaluated with Creighton-Nebraska score and circle draw test after 1 year. We checked simple AP, lateral, axial and Broden's view preoperatively and 1 year after surgery, and compared $B{\ddot{o}}hler$ angle and Gissane angle. Results: By Creighton-Nebraska score, Sanders type 2 was 86.4, type 3 was 74.3, type 4 was 62.4. And by circle draw test, type 2 was 8.9 cm, type 3 was 7.2 cm, type 4 was 5.9 cm. $B{\ddot{o}}hler$ angle and Gissane angle were $7.6^{\circ}$, $102.4^{\circ}$, and it increased to $23.5^{\circ}$, $128.6^{\circ}$ after postoperative 1 year. Conclusion: Limited posterior approach for the surgical treatment of intraarticular fracture of calcaneus was considered to an effective treatment modality.

• Journal of Korean Foot and Ankle Society
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• v.19 no.1
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• pp.35-38
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• 2015

The checkrein deformity describes tethering of the flexor hallucis longus tendon, which mainly occurs after fracture of the distal tibia. The deformity increases with dorsiflexion of the ankle and decreases or disappears with plantarflexion of the ankle. In some cases, the deformity may occasionally include the second and third toes. In the current study, the authors experienced secondary checkrein deformity of all lesser toes after open reduction and plate fixation for comminuted fracture of the calcaneus. As a treatment, plate and screws were removed, followed by an additional medial incision which showed a partially ruptured flexor digitorum longus tendon with severe adhesion. Resection of the adhesed tendon and tenodesis of its distal portion to the flexor hallucis longus was performed for correction of the checkrein deformity. Then the lessor toe checkrein deformity recovered immediately. The authors report on this rare lessor toe checkrein deformity after calcaneal fracture fixation with a review of literature.

• Journal of Korean Foot and Ankle Society
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• v.7 no.2
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• pp.258-262
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• 2003

Avulsion fracture of the calcaneal tuberosity is an uncommon injury. Usually it occurs from indirect trauma, and can be seen in old patients with osteoporosis or in patients with diabetic neuropathy. Follow-up studies showed healing of the fracture in most cases, but skeletal deformity may develop in some cases. Therefore we should take plain X-ray evaluations in diabetic patients with foot and ankle pain, even though there have been no definite trauma history. Four cases of calcaneus avulsion fracture were treated operatively in diabetic patients, and reported.

• The Journal of the Korean bone and joint tumor society
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• v.2 no.1
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• pp.111-115
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• 1996

Benign osteoblastoma, a rare tumor which forms osteoid and woven bone, represents 3% of benign and 1% of all primary bone tumors. It can involve anywhere in the axial skeleton, which is most common in the spine (34%). But the lesion of the calcaneus is extremely rare. The ratio of males to females is 2:1, with 80 percent of the patients being under thirty years of age. Pain is the most common symptom and rarely pathologic fracture. Osteoblastoma is a benign tumor but has a high recurrence rate after intracapsular malignant change. Therefore, choice of surgical procedure is the 'enbloc' resection. Authors have experienced a case of osteoblastoma developed in calcaneus. The treatment was wide resection and triple arthrodesis. We have reported here the case in which osteoblastoma occured in calcaneus of the right foot.

• Journal of Korean Foot and Ankle Society
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• v.7 no.2
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• pp.238-249
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• 2003

Purpose: To report the clinical result of the intraarticular calcaneus fracture after open reduction and internal fixation with plate by lateral approach. Materials and Methods: Thirty-six calcaneal fractures of 33 patients(29 men and 4 women) were treated by open reduction and internal fixation using an lateral approach from March, 1997 to May, 2002 and were followed more than one year. The autogenous iliac bone graft was done in 2 cases but the others didn't. Radiographically B?hler angle and Gissane angle on simple lateral radiograph were measured and in the 15 cases, the step-off(gap) of posterior facet joint on post-operative CT images were followed. The Salama method was used for evaluation of clinical results. Results: According to Sanders classification, 19 cases of the 36 cases were classified as type II. Type III fracture were found in 12 cases and type IV in 5 cases. The following results were obtained: twenty-two cases(61.1%) out of 36 cases were estimated as good or excellent. The good results or more were obtained in 15 cases(78.9%) in type II and 7 cases(58.3%) in type ill, but no case in type IV. B?hler angles were improved from preoperative average 1.6?to postoperative average 23.4?, Gissane angle was improved from preoperative 107.2?to postoperative 122.8?, respectively. Among 36 cases, Computed tomography was carried out in 15 cases. The postoperative step-off (gap) of posterior facet joint on computed tomography was filled with cancellous bone. Satifactory results was obtained in 7 cases with 2mm gap or less and in 6 cases of 2-5mm. There were no satifactory results in 2 cases with 5mm gap or more. Conclusion: Open reduction and internal fixation for intra-articular fracture of calcaneus was thought to be a good treatment modality. It is thought that the lateral approach is one of the good one for surgical treatment, and that accurate reduction of the posterior facet, acceptable recovery of B?hler angle are more important to obtain best results.

• Journal of Korean Foot and Ankle Society
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• v.17 no.2
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• pp.143-149
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• 2013

Purpose: Open reduction and internal fixation of calcaneal fracture using plate has been used. While numerous plates have been manufactured, most of the conventional plates are designed for westerners, realistically the size is larger for Korean. The domestic products, on the other hand, often have the undesirable screw holes and path. Therefore, we measured the radiologic parameter of Korean calcaneus for providing the plate and screw hole placements. Materials and Methods: We measured the outer lines and angles with over the 20 years old 291 females and 322 males. A: Length of inferior plane of calcaneus, B: Length of anterior plane of calcaneus, C: Length from line A to sinus tarsi, D: Length from line A to posterior point of posterior facet, E: Length from line A to calcaneal tuberosity, F: Length of posterior facet, G: Length from anterior point of line A to C, H: Length from line C to line D, a: Angle between A and B, b: Gissane angle, c: Bohler angle, d: Calcaneal pitch angle using Marosis m-view$^{(R)}$. Results: Mean A, B, C, D, E, F, G, H were 63.6, 26.4, 23.2, 43.7, 40.5, 26.9, 12.8, 18.1 mm. Mean a, b, c, d angle were 105.8, 122.4, 32.4, $20.5^{\circ}$. Male's calcaneus is significantly bigger than female's (p<0.001). Conclusion: AP calcaneus length 63.6 mm, maximal height 43.7 mm is considered to be helpful in making the Korean calcaneal plate.

• Journal of Korean Foot and Ankle Society
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• v.21 no.4
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• pp.165-169
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• 2017

Secondary soft tissue injuries can occur from the pressure of the displaced fragment of posterior calcaneal tuberosity in calcaneal tongue-type fractures and calcaneal tuberosity avulsion fractures. The soft tissue injury can be prevented by immediate reduction of the displaced fragments. Various techniques can be used to fix the fracture fragments, but the stability of fixation and minimal invasiveness to soft tissue should be considered. This paper reports the successful outcomes of patients with soft tissue compromises in calcaneal tongue-type fractures and calcaneal tuberosity avulsion fractures. The fixation technique of a large cannulated screw and simple cerclage wiring is believed to be a useful surgical option for the treatment of secondary soft tissue compromised calcaneal fractures.

• Journal of Korean Foot and Ankle Society
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• v.14 no.2
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• pp.157-160
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• 2010

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.

• Journal of Korean Foot and Ankle Society
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• v.10 no.2
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• pp.271-273
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• 2006

In closed calcaneus fractures, the occurrence of FHL interposition in subtalar joint is relatively rare and difficult to diagnosis preoperatively. But careful physical examination and significant radiologic findings could be useful tools to diagnosis preoperatively. This findings is shearing off a superior medial fragment made up of the sustentaculum talus connected to a significant portion of the medial wall and medial aticular surface of the posterior facet.