Radiographic evaluation of calcaneal fractures: to measure or not to measure

Abstract

Objective The aim of this study was to correlate the functional outcome after treatment for displaced intraarticular calcaneal fracture with plain radiography. Design The design was a prognostic study of a retrospective cohort with concurrent follow-up. Patients A total of 33 patients with a unilateral calcaneal fracture and a minimum follow-up of 13 months participated. Patients filled in three disease-specific questionnaires, graded their satisfaction and the indication for an arthrodesis was noted. Standardised radiographs were made of the previously injured side and the normal (control) side. Different angles and distances were measured on these radiographs and compared with values described in the literature. The differences in values in angles and distances between the injured and uninjured (control) foot were correlated with the outcome of the questionnaires, and the indication for an arthrodesis. Results None of the angles correlated with the diseasespecific outcome scores. Of the angles only the tibiotalar angle correlated with the VAS (r=0.35, p=0.045) and only the absolute foot height correlated with the indication for an arthrodesis (odds=0.70, CI=0.50-0.99). Conclusion In this study the radiographic evaluation correlated poorly with the final outcome. Measurements on plain radiographs seem not to be useful in determining outcome after intra-articular calcaneal fractures.

Predicting loss of height in surgically treated displaced intra-articular fractures of the calcaneus

“…Functional outcome, as measured using patient-reported outcome measures, was not used. Previous research showed that measurements on plain radiographs were not useful in determining outcome after intra-articular calcaneal fractures [22]. However, they are useful for determining fracture healing, alignment and surgical restoration of anatomy.…”

“…However, the subtalar joint frequently collapses (calcaneal collapse) post-operatively to some extent, which can be seen at radiological follow-up [11,14,24]. Several authors noted a correlation between initial BA and outcome [3,10,15,18,22,24]. The BA at time of admission appears to be a valuable prognosticator for functional longterm results [18].…”

“…The BA was measured on a lateral radiograph, as described previously, at three different time points: pre-operatively, directly following surgery and at one year follow-up [22]. In patients in whom a secondary arthrodesis was deemed necessary, BA was measured prior to this procedure.…”

In Brief: Fractures in Brief

“…Also as reported by Sanders, Crosby and Fitzgibbons classified fractures as nondisplaced, displaced or comminuted; Sanders further classified fractures according to the number and location of posterior facet articular fragments on CT [4]. There is little evidence that these classification systems can be applied reliably [5], let alone point to biologically distinct entities, although there is evidence that with the Sanders' classification, higher types correlate with worse prognosis.…”

Ankle Arthrodesis With Three Cancellous Screws

“…го лечения выполняли: рентгенографию обоих голеностопных суставов в двух стандартных про-екциях и в боковой проекции в положении стоя с нагрузкой для определения угла между лини-ями, проведенными вдоль оси большеберцовой кости и оси шейки таранной кости (бокового та-ранно-большеберцового угла) [19,22]. Также про-водили рентген-функциональное исследование в боковой проекции, что позволяло оценить сум-марную подвижность суставов среднего отдела стопы в сагиттальной плоскости при максималь-ном тыльном и подошвенном сгибании (опреде-ляли углы между осью таранной кости и длинной осью первой плюсневой кости в крайних точках движения).…”