Intra-articular calcaneal fractures: computed tomographic analysis.

Area of Science:

• Orthopedic Surgery
• Radiology
• Trauma Management

Background:

• Intra-articular calcaneal fractures are complex injuries.
• Accurate classification and assessment are crucial for patient outcomes.
• Traditional plain film radiography has limitations in evaluating these fractures.

Purpose of the Study:

• To evaluate the utility of computed tomography (CT) in analyzing intra-articular calcaneal fractures.
• To compare CT findings with the Essex-Lopresti classification.
• To assess CT's role in preoperative planning and identifying soft tissue injuries.

Main Methods:

• Retrospective analysis of 21 intra-articular calcaneal fractures using CT scans.
• Fractures categorized using the Essex-Lopresti classification.
• Comparison of CT findings with plain film radiography.

Main Results:

• CT revealed joint depression (57%) and comminuted (43%) fracture types, with no tongue-type fractures.
• Posterior calcaneal facet involved in 100% of cases; medial facet in 25%.
• CT identified additional fracture components and soft tissue injuries (e.g., peroneal tendon displacement) missed by plain films.

Conclusions:

• CT provides a more comprehensive evaluation of intra-articular calcaneal fractures than plain films.
• CT aids in detailed fracture subclassification, potentially improving prognosis.
• CT facilitates improved patient management, from acute care to chronic pain analysis.