Prognostic value of four classifications of calcaneal fractures.
BACKGROUND
The purpose of this study was to assist surgeons treating calcaneal fractures in choosing the most predictive fracture classification and clinical outcome tool.


METHODS
For 152 patients (189 calcaneal fractures; average followup, 9.9 years), all fractures were classified in accordance with the Essex-Lopresti, OTA, Regazzoni, and Sanders classifications and matched with the following scores: AOFAS score, CNHF, FOA, MFS, Rowe, MFA, SF-36, and VAS.


RESULTS
The Essex-Lopresti classification showed no statistically significant relation with any of the clinical scores (p > 0.05). The OTA classification related statistically significant with the MFS (p = 0.006), AOFAS score (p = 0.013), FOA (p = 0.019), Rowe (p = 0.0027), and MFA score (p = 0.03). The Regazzoni classification correlated with the AOFAS score (p = 0.003), MFS (p = 0.002), Rowe (p = 0.002), CNHF (p = 0.0001), FOA (p = 0.003), MFA score (p = 0.002), and VAS (p = 0.005). The Sanders classification corrrelated with the AOFAS score (p = 0.007), MFS (p = 0.001), Rowe (p = 0.001), CNHF (p = 0.024), FOA (p = 0.021), MFA score (p = 0.036), and VAS (p = 0.014).


CONCLUSIONS
Compared to radiological based classifications, the CT based classifications, especially the Regazzoni and Sanders classifications, exhibited higher prognostic value compared to ultimate outcome scores.
Rubino
Raffaele
R
Orthopedic Traumatologic Department, University Hospital of Basel, 4031 Basel, Switzerland.
Valderrabano
Victor
V
Sutter
Paul Martin
PM
Regazzoni
Pietro
P