J Korean Fract Soc.  2004 Jul;17(3):249-256. 10.12671/jkfs.2004.17.3.249.

Postoperative Evaluation of Displaced Intra-articular Calcaneal Fractures by Computed Tomography

• Kim WS
• Kim KK
• Chung WY
• Lee WS
• Kim YC
• Jeon TS
• Kim DH
• Cho SJ
• Hwang CM

• KMID: 1583684
• DOI: http://doi.org/10.12671/jkfs.2004.17.3.249

Abstract

PURPOSE: The purpose of the present study was to define the factors that affect the treatment and clinical result of displaced calcaneal fracture with use of the pre- operative and final follow-up computed tomography scanning.
MATERIALS AND METHODS
Present study included the 17 patients(18 feet) whom we performed surgery for displaced intra-articular calcaneal fracture at our institution between March 2000 and March 2002 and had a minimum follow-up of 12 months. For all patients, the Bohler's angle and posterior facet incongruity were measured with computed tomography pre- and post-operatively. The Creighton-Nebraska Health Foundation Assessment Scale for Fractures of the Calcaneus (CN scale) was used to evaluate the clinical results.
RESULTS
Of all eighteen fractures, the clinical results were excellent in three (16.6%), good in six (33.3%), fair in six (33.3%), and poor in three (16.6%). The Bohler's angle averaged 21degrees, 15degrees, 27degrees, 25degrees at final follow-up in each above clinical result group. The step-off averaged 1.0, 1.6, 3.9 and 6.0 mm and the average range of motion of the subtalar joint at final follow-up were 85, 76, 60 and 45% of normal. CT evaluation showed intra-articular screws in the posterior subtalar joint in three (16.6%) of the eighteen fractures but their average clinical result was good (80.3 points).
CONCLUSION
The restoration of the congruity and range of motion of posterior subtalar joint are considered important factor that affect clinical result.

Keyword

Calcaneus; Fracture; Joint incongruity; Computed tomography

MeSH Terms

Calcaneus
Follow-Up Studies
Humans
Range of Motion, Articular
Subtalar Joint