A Study on the Estimation of Calcaneal Width Using a Correlation of Calcaneal Length and Width

Dong-il Chun; Shu Chiang Hwang; Jae-ho Cho; Sung-Woo Choi; Yong Beom Kim; Sung Hun Won

doi:10.14193/jkfas.2017.21.2.61

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Chun, Hwang, Cho, Choi, Kim, and Won: A Study on the Estimation of Calcaneal Width Using a Correlation of Calcaneal Length and Width

Original Article

J Korean Foot Ankle Soc 2017;21(2):61-65.

Published online: 19 June 2017

DOI: https://doi.org/10.14193/jkfas.2017.21.2.61

A Study on the Estimation of Calcaneal Width Using a Correlation of Calcaneal Length and Width

Dong-il Chun, Shu Chiang Hwang, Jae-ho Cho^*, Sung-Woo Choi, Yong Beom Kim, Sung Hun Won

Department of Orthopaedic Surgery, Soonchunhyang University Seoul Hospital, Seoul, Chuncheon, Korea

^*Department of Orthopaedic Surgery, Hallym University Chuncheon Sacred Heart Hospital, Chuncheon, Korea

Corresponding Author: Sung Hun Won Department of Orthopaedic Surgery, Soonchunhyang University Seoul Hospital, 59 Daesagwan-ro, Yongsan-gu, Seoul 04401, Korea Tel: 82-2-709-9250, Fax: 82-2-710-3191, E-mail: orthowon@gmail.com

Received 19 April 201726 May 2017 Accepted 29 May 2017

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose:

The purpose of this study was to determine the correlation and ratio between the calcaneal length and width for predicting the width of calcaneus.

Materials and Methods:

A total of 190 feet (190 patients) were included based on computed tomography scans. The length of calcaneus (CL) was measured on the line connecting the center of a circle tangent to the cortical margin in the anterior and posterior parts of the calcaneus in a sagittal plane (W1, W2). The width of the calcaneus was defined as the horizontal line of each part (W1, W2, W3) on the same axial plane. The relationship between the measurement was determined through a correlation analysis. The reliability was assessed based on intraclass correlation coefficients.

Results:

The CL and widths of calcaneus (W1, W2, W3) had a good positive correlation (r=0.848 [W1/CL], r=0.738 [W2/CL], r=0.769 [W3/CL]; p<0.001). The mean CL and widths ratios were 0.33 (W1/CL), 0.37 (W2/CL), and 0.37 (W3/CL). Using these ratios to estimate the widths by multiplying each ratio by the measured calcaneal length, we found a difference between the estimated calcaneal widths and the actual measured calcaneal widths values was 0.25 mm, 0.43 mm, and 0.16 mm. All measurements showed good-to-excellent inter- and intraobserver reliability.

Conclusion:

This study analyzed the correlation and ratio between the length and width of the calcaneus. The results will help orthopedic surgeons fixate screws in a stable manner to prevent iatrogenic injuries to the medial neurovascular structures of the calcaneus.

Keywords: Calcaneus, Imaging, Three-dimensional, Correlation

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Figure 1.

Postoperative radiograph shows fixated screws of lateral to medial direction, and shows (asterisk) penetrates medial cortex of calcaneus.

Figure 2.

Axial cutting level was decided depend on sagittal plane level involving a line connecting the center of a circle tangent to the cortical margin in the anterior (W1) and posterior (W3) parts of the calcaneus in the sagittal plane.

Figure 3.

(A) The length of calcaneus (CL) measured on the line connecting the center of a circle tangent to the cortical margin in the anterior (W1) and posterior (W3) parts of the calcaneus in the sagittal plane. (B) The width of the calcaneus is defined as horizontal line of each part (W1, W2, W3) on same axial plane. L: length.

Table 1.

Correlation between CL and Each Widths of Calcaneus

W1	W2	W3
CL 0.848 (p<0.001)	0.738 (p<0.001)	0.769 (p<0.001)

CL: length of calcaneus, W1: width of anterior calcaneus, W2: width of middle calcaneus, W3: width of posterior calcaneus.

Table 2.

Ratios of CL and Each Widths and Difference between Each Measured and Predicted Widths of Calcaneus

	W1/CL	W2/CL	W3/CL
Ratio	0.33±0.04	0.37±0.05	0.37±0.04
Difference (mm)	0.25±3.1	0.43±4.3	0.16±3.1
IQR (Q1∼Q3)	―1.4∼1.9	―1.4∼1.5	―2.1∼1.4

Values are presented as mean±standard deviation or interquartile range (IQR). CL: length of calcaneus, W1: width of anterior calcaneus, W2: width of middle calcaneus, W3: width of posterior calcaneus.

Table 3.

Interobserver and Intraobserver Reliability of Radiologic Measurements

Radiographi measuremennt	Interobserver		Intraobserver
Radiographi measuremennt	ICC	95% CI	ICC	95% CI
CL	0.919	0.882∼0.941	0.915	0.897∼0.927
W1	0.855	0.826∼0.885	0.913	0.892∼0.927
W2 W3	0.863 0.837	0.823∼0.874 0.795∼0.875	0.897 0.875	0.865∼0.910 0.862∼0.901

ICC: intraclass correlation coefficient, CI: confidence interval, CL: length of calcaneus, W1: width of anterior calcaneus, W2: width of middle calcaneus, W3: width of posterior calcaneus.

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