Subtalar Dislocation: Long-Term Follow-Up and CT-Morphology

Abstract

Introduction: Although rare, subtalar dislocations are severe injuries with long-term alterations such as clinical dysfunction or painful posttraumatic arthritis. The objective of this study was to investigate long-term morphological changes of subtalar dislocations and to correlate them to clinical function. Based on the conclusions, suggestions for therapy guidelines were made in order to improve the functional outcome. Methods: Twenty-two patients (12 with a medial, 9 with a lateral and 1 with an anterior dislocation) were re-examined with an average follow-up time of 10 years. Radiological results of a computer tomography examination of the hindfoot were related to the clinical outcome, and both were discussed in the context of further parameters, such as additional injuries, time until reduction, and post-reduction treatment. Results: Additional injuries were found to affect the clinical outcome and/or the radiological changes. Predictive factors for limited range of motion were severe skin trauma and traumatic brain injuries. Factors that predicted both poor clinical function and clear signs of arthritis included complex talus, ankle and calcaneus fractures, long time until reduction, and infection. Conclusions: In many cases, radiological results can be correlated to clinical outcomes. However, the modulating effects of additional injuries should be considered when planning therapy. In cases with additional fractures of the talus and the calcaneus, suffering pain may be reduced by an early arthrodesis of the talo-calcanear joint. In cases involving a long stay on an intensive care unit, early functional treatment by passive motion should be discussed in special cases to improve the clinical outcome.

Real-Time Automated Segmentation and Classification of Calcaneal Fractures in CT Images

“…We obtained 2210 CT Digital Imaging and Communications in Medicine (DICOM) images from the datasets with assessment and evaluation of the fracture type information [1][2][3][4][5][6][7][8][9][10][11][12][13], radiopedia (https:// radiopaedia.org/), anesthesia key (https://aneskey.com/fractures-and-dislocations-of-the-tarsal-bones/), and CT images from two patients with three anatomical plane orientations. The dataset consists of 815 coronal images, 777 transverse images, and 618 sagittal images.…”

“…Bleeding fractures into the plane of the fascial, which surrounds the heel, produce severe pain above the fracture and may result in a leg compartment syndrome [5]. Furthermore, calcaneal fractures have presented a significant challenge for orthopedic surgeons in patients' treatment [6,7]. So, detection of the calcaneal fracture is an important subject for patient diagnostic decisions and treatment planning [8,9].…”