[Calcaneal fractures: guidelines for the diagnosis with computerized tomography]

Area of Science:

• Orthopedic Surgery
• Radiology
• Foot and Ankle Trauma

Background:

• Calcaneal fractures are complex injuries requiring precise evaluation.
• The Italian Surgical Society of the Foot classification system offers a framework for categorizing these fractures.
• Radiologic assessment, particularly of the posterior facet and talamus, is critical for understanding fracture patterns.

Purpose of the Study:

• To evaluate calcaneal fractures using computed tomography (CT) based on the Italian Surgical Society of the Foot classification.
• To detail the characteristics and frequency of different calcaneal fracture types, focusing on talamus involvement.
• To highlight the importance of specific radiologic findings for accurate diagnosis and treatment planning.

Main Methods:

• Retrospective analysis of 31 cases of calcaneal fractures.
• Utilized CT scans with thin axial and coronal slices, supplemented by sagittal reconstructions.
• Fractures were classified according to the Italian Surgical Society of the Foot system, focusing on the posterior facet and talamus.

Main Results:

• Talamus fractures were the most frequent (26/31 cases), often characterized by a sagittal fracture line dividing the bone into substentacular and tuberosity fragments.
• Fracture severity was determined by displacement and depression (Type I, II, III).
• Associated findings like calcaneus-cuboid facet involvement and posterior facet comminution were noted as worsening factors.

Conclusions:

• CT imaging is highly effective for evaluating calcaneal fractures, especially when using thin slices and multiplanar reconstructions.
• Accurate classification based on talamus involvement and displacement is essential for managing calcaneal fractures.
• Attention to less common fracture sites, such as the dorsal prominence and posterior tuberosity, is necessary for comprehensive assessment.