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KMID : 1130920140180040165
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Journal of Korean Foot and Ankle Society
2014 Volume.18 No. 4 p.165 ~ p.172
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Correlation Analysis of Reduction for Intra-Articular Calcaneal Fracture and Clinical Outcomes Using Postoperative Computed Tomography
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Eom Joon-Sang
Joo Young-Deuk
Kim Seong-Jun
Shin Min-Ho
Lee Dong-Oh
Jung Hong-Geun
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Abstract
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Purpose: We evaluated the correlation of postoperative clinical outcomes and radiologic findings using computed tomography and simple X-ray in intra-articular calcaneal fractures.
Materials and Methods: The current study is based on 41 feet, 38 patients with displaced intra-articular fracture who underwent surgical treatment with at least one year of follow-up. Evaluation of clinical outcome included American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, visual analogue scale (VAS) score, and subjective satisfaction. A simple X-ray was used in evaluation of preoperative and postoperative Gissane angle, BOhler angle, and calcaneal fracture width. Computed tomography scan was performed for evaluation of preoperative and postoperative articular step-off and articular gap in all cases. Finally, we evaluated the correlation of the postoperative clinical outcomes and radiologic findings based on the measurement.
Results: The average postoperative AOFAS score and VAS score was 84.1±8.5 and 2.2±2.2. Subjective satisfaction was excellent in 15 cases, good in 19 cases, and fair in seven cases. The average BOhler angle was restored from 11.1° to 24.7° (p<0.05), Gissane angle was changed from 121.0° to 119.0° (p>0.05), and the average width was restored from 45.8 to 35.0 mm (p<0.05). The average articular stepoff and gap were decreased from 6.3 to 2.0 mm and from 11.1 to 4.6 mm, respectively (p<0.05). No significant correlations were observed between the clinical outcome and Gissane angle, BOhler angle, and width, and there was no significant correlation between the clinical outcome and Sanders classification. However, postoperative articular step-off showed correlation with VAS and AOFAS score and articular gap showed correlation with VAS score.
Conclusion: The clinical outcome did not show correlation with BOhler angle and Gissane angle but did show correlation with anatomical reduction of the posterior facet joint.
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KEYWORD
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Calcaneal fracture, Articular step-off, Articular gap, Computed tomography
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