Preoperative and postoperative evaluation of intra-articular fractures of the calcaneus based on computed tomography scanning.
OBJECTIVE
To define the relationship between postoperative congruency of the posterior facet of the subtalar joint based on computed tomography (CT) and clinical results.


METHODS
Preoperative and postoperative CT scans were taken prospectively and analyzed.


METHODS
University medical center.


METHODS
Twenty-nine displaced fractures in twenty-five patients.


METHODS
All patients were treated with open reduction and internal fixation without bone graft.


METHODS
Postoperative CT findings were classified into three groups, according to the degree of displacement: anatomic, no displacement; nearly anatomic, displaced less than two millimeters; and approximate, displaced more than two millimeters.


RESULTS
The reduction state after operative treatment for the cases with more comminution showed worse results when analyzed in both preoperative and postoperative CT scans. Fifteen of seventeen fractures (88 percent) with anatomic reduction and seven of eight fractures (87 percent) with nearly anatomic reduction had excellent or good clinical results. In contrast, no fracture with an approximate reduction had an excellent result.


CONCLUSIONS
An excellent or good clinical result can be expected when the postoperative displacement of the posterior facet of the subtalar joint is less than two millimeters.
Song
K S
KS
Department of Orthopedic Surgery, School of Medicine, Keimyung University, Daegu, Korea.
Kang
C H
CH
Min
B W
BW
Sohn
G J
GJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D000843:Ankle Joint / Q000000981:diagnostic imaging*; D002111:Calcaneus / Q000000981:diagnostic imaging* / Q000293:injuries* / Q000601:surgery; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods; D050723:Fractures, Bone / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D011183:Postoperative Complications / Q000000981:diagnostic imaging*; D011300:Preoperative Care; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed