Department of Orthopedic Surgery, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.
Foot Ankle Surg. 2022 Jan;28(1):88-92. doi: 10.1016/j.fas.2021.02.002. Epub 2021 Feb 5.
Calcaneal fractures may have lifelong debilitating sequences, if not treated properly. Identifying different types of calcaneal fractures based on the computed tomography (CT) scans can increase our conception about these fractures.
In a cross-sectional study, the available CT images of all consecutive patients with the diagnosis of calcaneal fracture, from January 2015 to December 2018, were reviewed to determine different patterns and types of these fractures.
CT images of 886 patients (mean age, 41.29 ± 14.9; range, 3-89 years; male/female, 4.86; pediatric: 3.7%) with 957 calcaneal fractures were evaluated. The peak incidence of calcaneal fractures was seen in patients between 30 to 39 years of age (29%). The rate of open fractures and bilateral involvements were 2.4% and 8.0%, respectively. Among 680 (71.0%) intra-articular calcaneal fractures, subtalar calcaneal fractures were the most common type (94.3%). The majority of intra-articular subtalar calcaneal fractures were displaced (95.0%) with calcaneocuboid joint (CCJ) involvement (59.9%). Fracture lines were extended to the CCJ in about 86.9% of Sanders type IV, 66.3% of type III, and 60.2% of type II. Among 261 extra-articular fractures (27.3%), calcaneal body fracture (55.6%) was the most frequent type, followed by medial tubercle fracture (24.1%), calcaneal tuberosity fracture (10.4%), Degan type I anterior process fractures (5.4%), Degan type II anterior process fracture (3.4%), and isolated lateral tubercle fracture (1.1%). Most of bilateral calcaneal fractures were intra-articular subtalar fractures with involvement of CCJ. Although majority of intra-articular calcaneal fractures were displaced; less than half of the extra-articular fractures were displaced.
Displaced intra-articular subtalar calcaneal fractures with CCJ involvement are the most frequent type of unilateral and bilateral calcaneal fractures. It appears that there is a correlation between Sanders type and the probability of CCJ involvement. Unlike intra-articular subtalar calcaneal fractures, the CCJ in the majority of extra-articular calcaneal body fractures was intact.
Level IV.
如果不进行适当的治疗，跟骨骨折可能会导致终身致残。通过 CT 扫描识别不同类型的跟骨骨折可以增加我们对这些骨折的认识。
在一项横断面研究中，回顾了 2015 年 1 月至 2018 年 12 月期间所有连续诊断为跟骨骨折患者的 CT 图像，以确定这些骨折的不同类型。
评估了 886 名患者（平均年龄 41.29 ± 14.9 岁；范围 3-89 岁；男/女 4.86；儿童：3.7%）的 957 例跟骨骨折的 CT 图像。跟骨骨折的高发年龄段为 30-39 岁（29%）。开放性骨折和双侧受累的发生率分别为 2.4%和 8.0%。在 680 例（71.0%）关节内跟骨骨折中，距下关节跟骨骨折最常见（94.3%）。大多数关节内距下关节跟骨骨折均有移位（95.0%），伴有跟骰关节（CCJ）受累（59.9%）。约 86.9%的 Sanders Ⅳ型、66.3%的Ⅲ型和 60.2%的Ⅱ型骨折线延伸至 CCJ。在 261 例关节外骨折（27.3%）中，跟骨体骨折（55.6%）最为常见，其次是内侧结节骨折（24.1%）、跟骨结节骨折（10.4%）、Degan Ⅰ型前突骨折（5.4%）、Degan Ⅱ型前突骨折（3.4%）和孤立性外侧结节骨折（1.1%）。大多数双侧跟骨骨折均为伴有 CCJ 受累的关节内距下关节跟骨骨折。虽然大多数关节内跟骨骨折有移位，但不到一半的关节外骨折有移位。
单侧和双侧跟骨骨折最常见的类型是伴有 CCJ 受累的移位关节内距下关节跟骨骨折。Sanders 分型与 CCJ 受累的概率之间似乎存在相关性。与关节内距下关节跟骨骨折不同，大多数关节外跟骨体骨折的 CCJ 保持完整。
IV 级。
