Wülker N, Zwipp H, Tscherne H
Unfallchirurgische Klinik, Medizinischen Hochschule Hannover.
Unfallchirurg. 1991 Apr;94(4):198-203.
Improvement of the diagnostic techniques applied in calcaneus fractures, particularly the increased use of computed tomography, calls for a detailed fracture classification. Thirty lower leg cadaver specimens were submitted to axial loading. Fracture lines could be divided into a relatively constant primary fracture, running from the posterior subtalar joint surface to the tuber calcanei, and highly variable secondary fractures. In order to classify the fracture specimens, the calcaneus was divided into four segments: the sustentacular segment, the posterior subtalar joint segment, the segment of the anterior process, and the tuberosity segment. In addition, the following joints were identified at the calcaneus: the posterior subtalar joint, the anterior subtalar joint, and the calcaneo-cuboid joint. Each specimen was classified by the number of segments (x) and the number of joints (y) affected, and accordingly labelled as x-segment, y-joint fracture. The addition of both numbers was used to grade the severity of the fracture. This classification was easily applicable to all 25 experimental fracture specimens, and also to 33 clinical cases.
跟骨骨折诊断技术的改进，尤其是计算机断层扫描使用的增加，需要详细的骨折分类。对30个小腿尸体标本施加轴向负荷。骨折线可分为一条相对恒定的主要骨折线，从距下后关节面延伸至跟骨结节，以及高度可变的次要骨折线。为了对骨折标本进行分类，将跟骨分为四个部分：载距突部分、距下后关节部分、前突部分和结节部分。此外，在跟骨处还确定了以下关节：距下后关节、距下前关节和跟骰关节。每个标本根据受影响的部分数量（x）和关节数量（y）进行分类，并相应标记为x部分、y关节骨折。两者数字相加用于对骨折严重程度进行分级。这种分类很容易应用于所有25个实验性骨折标本，也适用于33个临床病例。
