The Comparison of Radiographic Parameters and Clinical Results after Operative Treatment of Displaced Intraarticular Calcaneal Fractures

Hong Moon Sohn; Jun Young Lee; Sang Ho Ha; Sueng Hwan Jo

doi:10.12671/jkfs.2007.20.3.227

Journal List > J Korean Fract Soc > v.20(3) > 1037589

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

Sohn, Lee, Ha, and Jo: The Comparison of Radiographic Parameters and Clinical Results after Operative Treatment of Displaced Intraarticular Calcaneal Fractures

Original Article

Journal of the Korean Fracture Society 2007; 20(3): 227-232.

Published online: 14 June 2016

DOI: https://doi.org/10.12671/jkfs.2007.20.3.227

The Comparison of Radiographic Parameters and Clinical Results after Operative Treatment of Displaced Intraarticular Calcaneal Fractures

Hong Moon Sohn, M.D., Jun Young Lee, M.D., Sang Ho Ha, M.D., Sueng Hwan Jo, M.D.

Department of Orthopaedic Surgery, College of Medicine, Chosun University, Gwangju, Korea.

Address reprint requests to: Jun-Young, Lee, M.D. Department of Orthopaedic Surgery, Chosun University Hospital, 588, Seosuk-dong, Dong-gu, Gwangju 501-717, Korea. Tel: 82-62-220-3147, Fax: 82-62-226-3379, leejy88@chosun.ac.kr

Abstract

Purpose

To evaluate the relationship between radiographic parameters and clinical results after operative treatment of the displaced intra-articular calcaneal fractures.

Materials and Methods

We analyzed 35 patients of unilateral displaced intraarticular calcaneal fractures who had operative treatment with minimum follow up of 1 year. At the last follow up, we measured the radiographic parameters including Bohler angle, Gissane angle, heel height, calcaneal length, talocalcaneal angle, talar declination angle, subtalar incongruity between normal and affected site. Clinical results were measured by Creighton-Nebraska Health Foundation Assessment Score (CNH). The correlation between the radiographic parameters and the clinical results were analysed by Pearson correlation method.

Results

Among the all radiographic parameters we analyzed, only subtalar incongruity shows strong negative linear correlation with clinical results. The average difference of subtalar incongruity between normal and affected site was 0.54 mm (0~2.5) and the correlation coefficients with CNH score was –0.784 (p=0.002).

Conclusion

We suggest that the subtalar incongruity is significantly correlated with the clinical results after operative treatment of the displaced intraarticular calcaneal fractures.

Keywords: Calcaneus, Intraarticular fracture, Radiographic parameters, Clinical results

Figures and Tables

Fig. 1

Radiographic parameters at ankle lateral view. BA: Böhler angle, GA: Gissane angle, TDA: Talar declination angle, TA: Talocalcaneal angle, HH: Heel height, CL: calcaneal length.

Fig. 2

Subtalar incongruity and CNH score shows strong correlation by Pearson correlation method (Correlation coefficient: 0.784, p=0.002).

Table 1

Radiologic data collected from patients

BA: Böhler angle, GA: Gissane angle, HH: Heel height, CL: Calcaneal length, TA: Talocalcaneal angle, TDA: Talar declination angle, SI: Subtalar incongruity, CNH: Creighton nebraska health foundation assessment sheet for fractures of the calcaneum.

References

1. Allan JH. The open reduction of fractures of the os calcis. Ann Surg. 1995; 141:890–900.

2. Burdeaux BD. Reduction of calcaneal fractures by the McReynolds medial approach technique and its experimental basis. Clin Orthop Relat Res. 1983; 177:87–103.

3. Chapman MW. Calcaneus fractures. In : Chapman MW, editor. Orthopaedic surgery. 3rd ed. Philadelphia: LWW;2001. p. 2966–2979.

4. Choi JC, Lee KS, Kim BS, Park BY, Cha JH. Open reduction and internal fixation of intraarticular calcaneal fractures by the extended lateral approach. J Korean Orthop Assoc. 1997; 32:370–375.

5. Crosby LA, Fitzgibbons T. Computerized tomography scanning of acute intra-articular fractures of the calcaneus. A new classification system. J Bone Joint Surg Am. 1990; 72:852–859.

6. Crosby LA, Fitzgibbons T. Intraarticular calcaneal fractures. Results of closed treatment. Clin Orthop Relat Res. 1993; 290:47–54.

7. Deyerle WM. Long term follow-up of fractures of the os calcis. Diagnostic peroneal synoviagram. Orthop Clin North Am. 1973; 4:213–227.

8. Essex-Lopresti P. The mechanism, reduction technique, and results in fractures of the os calcis. Br J Surg. 1952; 39:395–419.

9. Ha SH, Pyo YB, Yoon HJ. Pecutaneous pinning for intra-articular calcaneal fracture. J Korean Orthop Assoc. 1994; 29:774–782.

10. Harding D, Waddell JP. Open reduction in depressed fractures of the os calcis. Clin Orthop Relat Res. 1985; 199:124–131.

11. Harris RI. Fractures of the os calcis. Treatment by early subtalar arthrodesis. Clin Orthop Relat Res. 1963; 30:100–110.

12. Hildebrand KA, Buckley RE, Mohtadi NG, Faris P. Functional outcome measures after displaced intra-articular calcaneal fractures. J Bone Joint Surg Br. 1996; 78:119–123.

13. Hutchinson F, Huebner MK. Treatment of os calcis fractures by open reduction and internal fixation. Foot Ankle Int. 1994; 15:225–232.

14. Kalamchi A, Evans JG. Posterior subtalar fusion. A preliminary report on a modified Gallie's procedure. J Bone Joint Surg Br. 1977; 59:287–289.

15. Kitaoka HB, Schaap EJ, Chao EY, An KN. Displaced intra-articular fractures of the calcaneus treated non-operatively. Clinical results and analysis of motion and ground-reaction and temporal forces. J Bone Joint Surg Am. 1994; 76:1531–1540.

16. Koval KJ, Sanders R. The radiologic evaluation of calcaneal fractures. Clin Orthop Relat Res. 1993; 290:41–46.

17. Kundel K, Funk E, Brutscher M, Bickel R. Calcaneal fractures: operative versus nonoperative treatment. J Trauma. 1996; 41:839–845.

18. Maxfield JE, McDermott FJ. Experiences with the Palmer open reduction of fractures of the calcaneus. J Bone Joint Surg Am. 1955; 37:99–106.

19. O’Connell F, Mital MA, Rowe CR. Evaluation of modern management of fractures of the os calcis. Clin Orthop Relat Res. 1972; 83:214–223.

20. Paley D, Hall H. Intra-articular fractures of the calcaneus. A critical analysis of results and prognostic factors. J Bone Joint Surg Am. 1993; 75:342–354.

21. Pennal GF, Yadav MP. Operative treatment of comminuted fractures of the Os calcis. Otrhop Clin North Am. 1973; 4:197–211.

22. Salama R, Benamara A, Weissman SL. Functional treatment of intra-articular fractures of the calcaneus. Clin Orthop Relat Res. 1976; 115:236–240.

23. Sanders R. Displaced intra-articular fractures of the calcaneus. J Bone Joint Surg Am. 2000; 82:225–250.

24. Sanders R, Fortin P, DiPasquale T, Walling A. Operative treatment in 120 displaced intraarticular calcaneal fractures. Results using a prognostic computed tomography scan classification. Clin Orthop Relat Res. 1993; 290:87–95.

25. Sangeorzan BJ, Benirschke SK, Carr JB. Surgical management of fractures of the os calcis. Instr Course Lect. 1995; 44:359–370.

26. Shim JI, Kim TS, Lee SJ, Lee SH, Yu CM, Kim YB. The classification and management of intraarticular calcaneal fracture based on computed tomography. J Korean Soc Fract. 1996; 9:742–749.

27. Shin DE, Kim JY, Shin DB, Kim YJ, Han SH, Soung YJ. Correlation of the clinical outcome and radiographic measurement of the calcaneal fractures. J Korean Soc Fract. 2001; 14:698–705.

TOOLS

Similar articles