Harnroongroj Thos, Chuckpaiwong Bavornrit, Angthong Chayanin, Nanakorn Pongtep, Sudjai Narumol, Harnroongroj Thossart
Department of Orthopedics Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
J Med Assoc Thai. 2012 Mar;95(3):366-77.
To review and group configurations of displaced articular calcaneal fracture advantaged for classification and radiographic fracture scores.
Between 2002 and 2011, medical records and radiographs of patients who sustained acute displaced articular calcaneal fractures were reviewed. The calcanealfracture configurations were grouped as avulsion, bending, burst, or combination. Radiographic displaced articular calcaneal fracture score was designed to include Bohler and Gissane angles, degrees of posterior subtalar joint line parallel, degrees of varus, and burst. The calcaneal fracture score was modified as power of the fracture response to treatment (PFRT). Prevalence of the fracture types, pre- and post-reduction fracture scores including PFRT were studied and statistically analyzed.
Sixty-four patients had 77 acute displaced articular calcaneal fractures. The classification consisted of type I avulsion, type II compression bending, type III compression burst, type IV avulsion burst, and type V bending burst. Type IV is the most common. The radiographic calcaneal fracture scores were 10 points. Pre-, post-reduction calcaneal fracture scores and PFRTof type I, II, III, IV, and V were 4.17 (0.41), 0 and 1 (0), 4.63 (2.13), 0.50 (0.93) and 0.84 (0.35), 6.94 (2.05), 3.18 (1.38) and 0.50 (0.27), 8.03 (1.12), 3.03 (2.42) and 0.62 (0.30), and 7.22 (2.11), 3.00 (2.50) and 0.59 (0.29) respectively. Statistical analysis showed significant difference (p < 0.05). PFRT for screw and pin fixation of type I plus II, IV and V were 1.00 (0) and 1.00 (0), 0.64 (0.27) and 0.60 (0.36), and 0.54 (0.28) and 0.51 (0.45) respectively. PFRT for plate of type III was 0.54 (0.16). PFRT for casting of type I plus II, III, and IV were 0.50 (0.71), 0.27 (0.46), and 0.35 (0.33) respectively.
The classification consisted of five types, which were based on injury mechanisms as avulsion, bending, and burst. The radiographic calcaneal fracture scores contained 10 points and were used for determining complexity of the fractures. PFRT was used for evaluating efficacy of fracture treatment.
回顾并对移位的关节面跟骨骨折的构型进行分组，以利于分类及影像学骨折评分。
回顾2002年至2011年期间急性移位关节面跟骨骨折患者的病历及X线片。跟骨骨折构型分为撕脱型、弯曲型、爆裂型或复合型。影像学移位关节面跟骨骨折评分设计为包括Bohler角和Gissane角、距下后关节线平行度、内翻度数及爆裂情况。跟骨骨折评分修改为骨折对治疗反应的强度（PFRT）。研究并统计分析骨折类型的患病率、复位前后的骨折评分（包括PFRT）。
64例患者有77例急性移位关节面跟骨骨折。分类包括I型撕脱骨折、II型压缩弯曲骨折、III型压缩爆裂骨折、IV型撕脱爆裂骨折和V型弯曲爆裂骨折。IV型最为常见。影像学跟骨骨折评分为10分。I型、II型、III型、IV型和V型复位前、复位后的跟骨骨折评分及PFRT分别为4.17（0.41）、0和1（0），4.63（2.13）、0.50（0.93）和0.84（0.35），6.94（2.05）、3.18（1.38）和0.50（0.27），8.03（1.12）、3.03（2.42）和0.62（0.30），以及7.22（2.11）、3.00（2.50）和0.59（0.29）。统计分析显示有显著差异（p<0.05）。I型加II型、IV型和V型螺钉及钢针固定的PFRT分别为1.00（0）和1.00（0），0.64（0.27）和0.60（0.36），以及0.54（0.28）和0.51（0.45）。III型钢板固定的PFRT为0.54（0.16）。I型加II型、III型和IV型石膏固定的PFRT分别为0.50（0.71），0.27（0.46）和0.35（0.33）。
该分类包括五种类型，基于损伤机制分为撕脱型、弯曲型和爆裂型。影像学跟骨骨折评分包含10分，用于确定骨折的复杂性。PFRT用于评估骨折治疗的疗效。
