Zhang Boyu, Lu Hao, Quan Yuan, Wang Yi, Xu Hailin
Orthopaedic and Traumatology, Peking University People's Hospital, No. 11 Xizhimen South Street, Beijing, 100044, China.
Key Laboratory of Trauma and Neural Regeneration (Peking University), Ministry of Education, Beijing, China.
Int Orthop. 2023 Jan;47(1):241-249. doi: 10.1007/s00264-022-05622-8. Epub 2022 Nov 4.
Calcaneal fractures have complex morphology, which brings great challenges to clinical treatment. The primary fracture lines could help us simplify the fracture. Fracture mapping technology can help surgeons understand the fracture morphology more intuitively. This study aims to develop a further understanding of calcaneal fractures by delineating the primary fracture lines through the fracture mapping technology.
Ninety cases of intra-articular calcaneal fractures were reviewed between March 2016 and January 2019 at a level 1 trauma centre. The CT data of these cases were reconstructed and reduced using software. We superimposed the primary fracture lines on a standard model and created the distribution and heat map of the intra-articular calcaneal fractures. SPSS 18.0 was used to count the differences between the different groups.
The primary fracture lines concentrated at the Gissane angle and the posterior articular surface, which could be summarized in two ring structures. There were 43 cases of fracture involving calcaneocuboid joint, including 32 cases of joint-depression fracture and 11 cases of tongue-type fracture. The area ratio of lateral fragment of simple tongue-type fracture is larger than joint-depression fracture.
The primary fracture lines of calcaneus were distributed in two rings on the surface of calcaneus. Based on the distribution of primary fracture rings, we integrated the classification of calcaneal fracture and proposed some treatment recommendations.
跟骨骨折形态复杂，给临床治疗带来巨大挑战。主要骨折线有助于我们简化骨折情况。骨折映射技术可帮助外科医生更直观地了解骨折形态。本研究旨在通过骨折映射技术描绘主要骨折线，进一步加深对跟骨骨折的认识。
回顾2016年3月至2019年1月在某一级创伤中心的90例关节内跟骨骨折病例。使用软件对这些病例的CT数据进行重建和缩减。我们将主要骨折线叠加在标准模型上，创建关节内跟骨骨折的分布和热图。使用SPSS 18.0统计不同组之间的差异。
主要骨折线集中在吉氏角和后关节面，可归纳为两个环形结构。有43例骨折累及跟骰关节，其中关节塌陷骨折32例，舌形骨折11例。单纯舌形骨折外侧骨折块的面积比大于关节塌陷骨折。
跟骨的主要骨折线分布在跟骨表面的两个环上。基于主要骨折环的分布，我们整合了跟骨骨折的分类并提出了一些治疗建议。
