[CT morphometry for calcaneal fractures and comparison of the Zwipp and Sanders classifications].
OBJECTIVE
The aim of the study is to correlate the CT-morphological changes of fractured calcaneus and the classifications of Zwipp and Sanders with the clinical outcome.


METHODS
In a retrospective clinical study, the preoperative CT scans of 75 calcaneal fractures were analysed. The morphometry of the fractures was determined by measuring height, length diameter and calcaneo-cuboidal angle in comparison to the intact contralateral side. At a mean of 38 months after trauma 44 patients were clinically followed-up. The data of CT image morphometry were correlated with the severity of fracture classified by Zwipp or Sanders as well as with the functional outcome.


RESULTS
There was a good correlation between the fracture classifications and the morphometric data. Both fracture classifying systems have a predictive impact for functional outcome. The more exacting and accurate Zwipp classification considers the most important cofactors like involvement of the calcaneo-cuboidal joint, soft tissue damage, additional fractures etc. The Sanders classification is easier to use during clinical routine.


CONCLUSIONS
The Zwipp classification includes more relevant cofactors (fracture of the calcaneo-cuboidal-joint, soft tissue swelling, etc.) and presents a higher correlation to the choice of therapy. Both classification systems present a prognostic impact concerning the clinical outcome.
Andermahr
J
J
Klinik und Poliklinik für Unfall, Hand-und Wiederherstellungschirurgie, Germany. jandermahr@t-online.de
Jesch
A B
AB
Helling
H J
HJ
Jubel
A
A
Fischbach
R
R
Rehm
K E
KE
D000328:Adult; D016025:Bone Transplantation; D002111:Calcaneus / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D005260:Female; D018409:Foot Injuries / Q000145:classification / Q000000981:diagnostic imaging* / Q000601:surgery; D005593:Fracture Fixation, Internal; D017102:Fracture Healing / Q000502:physiology; D050723:Fractures, Bone / Q000145:classification / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D011379:Prognosis; D011859:Radiography; D012189:Retrospective Studies; D016896:Treatment Outcome