J Korean Foot Ankle Soc.  2014 Dec;18(4):165-172. 10.14193/jkfas.2014.18.4.165.

Correlation Analysis of Reduction for Intra-Articular Calcaneal Fracture and Clinical Outcomes Using Postoperative Computed Tomography

Affiliations
  • 1Department of Orthopaedic Surgery, Konkuk University School of Medicine, Seoul, Korea. jungfoot@hanmail.net
  • 2The Armed Forces Yangju Hospital, Yangju, Korea.
  • 3LCT Hospital, Suwon, Korea.

Abstract

PURPOSE
We evaluated the correlation of postoperative clinical outcomes and radiologic findings using computed tomography and simple X-ray in intra-articular calcaneal fractures.
MATERIALS AND METHODS
The current study is based on 41 feet, 38 patients with displaced intra-articular fracture who underwent surgical treatment with at least one year of follow-up. Evaluation of clinical outcome included American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, visual analogue scale (VAS) score, and subjective satisfaction. A simple X-ray was used in evaluation of preoperative and postoperative Gissane angle, Bohler angle, and calcaneal fracture width. Computed tomography scan was performed for evaluation of preoperative and postoperative articular step-off and articular gap in all cases. Finally, we evaluated the correlation of the postoperative clinical outcomes and radiologic findings based on the measurement.
RESULTS
The average postoperative AOFAS score and VAS score was 84.1+/-8.5 and 2.2+/-2.2. Subjective satisfaction was excellent in 15 cases, good in 19 cases, and fair in seven cases. The average Bohler angle was restored from 11.1degrees to 24.7degrees (p<0.05), Gissane angle was changed from 121.0degrees to 119.0degrees (p>0.05), and the average width was restored from 45.8 to 35.0 mm (p<0.05). The average articular step-off and gap were decreased from 6.3 to 2.0 mm and from 11.1 to 4.6 mm, respectively (p<0.05). No significant correlations were observed between the clinical outcome and Gissane angle, Bohler angle, and width, and there was no significant correlation between the clinical outcome and Sanders classification. However, postoperative articular step-off showed correlation with VAS and AOFAS score and articular gap showed correlation with VAS score.
CONCLUSION
The clinical outcome did not show correlation with Bohler angle and Gissane angle but did show correlation with anatomical reduction of the posterior facet joint.

Keyword

Calcaneal fracture; Articular step-off; Articular gap; Computed tomography
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