Three-dimensional and two-dimensional computerized tomographic demonstration of calcaneus fractures

The objective of the study was to illustrate the diagnostic quality of three-dimensional computed tomography (3DCT) and to document its usefulness for detecting gross changes in articular surfaces of the calcaneus and posterior articular facet (PAF). Superior view 3DCT images of 51 calcanei in 39 different patients were reviewed based on bony fragments produced by primary fracture lines and involvement of the PAF. Of 49 intraarticular fractures examined, there were two severely comminuted and 47 comminuted fractures. Main characteristics of both groups were described. Important findings best seen on 3DCT images were the number and configuration of displaced PAF fragments, fracture lines separating the anterior process and the middle facet, and the extension of fracture lines into the calcaneocuboid facet. The double density sign seen in plain x-rays was identified as a double articular sign in 3DCT images.