Andermahr J, Jesch A B, Helling H J, Jubel A, Fischbach R, Rehm K E
Klinik und Poliklinik für Unfall, Hand-und Wiederherstellungschirurgie, Germany.
Z Orthop Ihre Grenzgeb. 2002 May-Jun;140(3):339-46. doi: 10.1055/s-2002-32473.
The aim of the study is to correlate the CT-morphological changes of fractured calcaneus and the classifications of Zwipp and Sanders with the clinical outcome.
In a retrospective clinical study, the preoperative CT scans of 75 calcaneal fractures were analysed. The morphometry of the fractures was determined by measuring height, length diameter and calcaneo-cuboidal angle in comparison to the intact contralateral side. At a mean of 38 months after trauma 44 patients were clinically followed-up. The data of CT image morphometry were correlated with the severity of fracture classified by Zwipp or Sanders as well as with the functional outcome.
There was a good correlation between the fracture classifications and the morphometric data. Both fracture classifying systems have a predictive impact for functional outcome. The more exacting and accurate Zwipp classification considers the most important cofactors like involvement of the calcaneo-cuboidal joint, soft tissue damage, additional fractures etc. The Sanders classification is easier to use during clinical routine.
The Zwipp classification includes more relevant cofactors (fracture of the calcaneo-cuboidal-joint, soft tissue swelling, etc.) and presents a higher correlation to the choice of therapy. Both classification systems present a prognostic impact concerning the clinical outcome.
本研究旨在将跟骨骨折的CT形态学改变以及Zwipp和Sanders分类与临床结果相关联。
在一项回顾性临床研究中，分析了75例跟骨骨折的术前CT扫描。通过与对侧完整侧相比测量高度、长度直径和跟骰关节角来确定骨折的形态学。在创伤后平均38个月时，对44例患者进行了临床随访。将CT图像形态学数据与按Zwipp或Sanders分类的骨折严重程度以及功能结果相关联。
骨折分类与形态学数据之间存在良好的相关性。两种骨折分类系统对功能结果均有预测作用。更精确准确的Zwipp分类考虑了最重要的辅助因素，如跟骰关节受累、软组织损伤、附加骨折等。Sanders分类在临床常规操作中更易于使用。
Zwipp分类包括更多相关辅助因素（跟骰关节骨折、软组织肿胀等），并且与治疗选择的相关性更高。两种分类系统对临床结果均有预后作用。
