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      Calcaneal fractures: radiological and CT evaluation and classification systems

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          Abstract

          Background and aim of the work: The calcaneus, the more lower bone of the body, has the task of supporting the axial load from the weight of the body. Calcaneal fractures represent about 1-2% of all fractures and 60% of the tarsal bones fractures. The articular involvement has been associated with a poor functional outcome. The aim of this work is to describe the radiologic evaluation, the classification systems, the morphological preoperative diagnostic imaging features of calcaneal fractures, highlighting the correlation with the choice of treatment and predictive capacity for the fracture surgical outcome. Methods: A PubMed search was performed for the terms Imaging calcaneus fracture, selecting articles in English language, published in the last two years, where preoperatively diagnostic imaging of fractures of the calcaneus are described. Case reports have not been included. Results: We have collected a number of data that provide important help in preoperative evaluation of calcaneal fractures, such as the new classification system created by Harnroongroj et al, the association of calcaneal fractures with fractures of other bone structures or soft tissue impairment, the use of calcaneotalar ratio in assessing the length of heel. Conclusions: These data suggest an approach geared to the specific choice of treatment and to improving patient outcomes. (www.actabiomedica.it)

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          Operative treatment in 120 displaced intraarticular calcaneal fractures. Results using a prognostic computed tomography scan classification.

          From January 1987 to September 1990, 132 displaced intraarticular calcaneal fractures were treated operatively using a lateral approach, lag screws, and side plate without bone graft. To evaluate the results, a classification for intraarticular calcaneal fractures was developed, based on standardized coronal and transverse computed tomography (CT) scans of both feet. Type 1 fractures were nondisplaced (and received nonoperative treatment); Type II were two-part or split fractures; Type III were three-part or split depression fractures; and Type IV were four-part or highly comminuted articular fractures. Results were evaluated using the Maryland Foot Score and repeat CT scans. One hundred twenty cases were available for a minimum of one year follow-up evaluation (range, 12-56 months; mean, 29.3 months). Roentgenographic evaluation of calcaneal body dimensions showed restoration of heel height (98%), width (110%), and length (100%) to virtually normal in all cases, regardless of preoperative displacement. Roentgenographically, articular reduction was anatomic in 68 of 79 (86%) Type II fractures, 18 of 30 (60%) Type III fractures, and 0 of 11 (0%) Type IV fractures. Excellent or good clinical results occurred in 58 of 79 (73%) Type II fractures, 21 of 30 (70%) Type III fractures, and one of 11 (9%) Type IV fractures. When excellent and good clinical results were compared by year, a distinct learning curve appeared (1987, 27%; 1988, 54%; 1989, 74%; 1990, 84%). Despite an improved outcome for Type II and III fractures with increasing surgical experience, the results of operative intervention in Type IV fractures were no better, even after four years.(ABSTRACT TRUNCATED AT 250 WORDS)
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            Displaced intra-articular fractures of the calcaneus.

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              The mechanism, reduction technique, and results in fractures of the os calcis.

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                Author and article information

                Journal
                Acta Biomed
                Acta Biomed
                Acta bio-medica : Atenei Parmensis
                Mattioli 1885 (Italy )
                0392-4203
                2018
                : 89
                : Suppl 1
                : 138-150
                Affiliations
                [1 ]Department of Emergency Radiology, S. Camillo Hospital, Rome, Italy
                [2 ]Department of Radiology, Careggi University Hospital, Florence, Italy
                [3 ]A.O.U. San Giovanni di Dio e Ruggi d’Aragona, Department of Radiology, Italy
                [4 ]Universita degli Studi del Molise, Department of Medicine and Health Science “V. Tiberio”, Campobasso, Italy
                [5 ]Università degli Studi della Campania Luigi Vanvitelli, Department of Internal and Experimental Medicine, Naples, Italy
                Author notes
                Correspondence: Vittorio Miele, MD Department of Radiology, Careggi University Hospital L.go G.A. Brambilla 3 - 50134 Florence (Italy) E-mail: vmiele@ 123456sirm.org
                Article
                ACTA-89-138
                10.23750/abm.v89i1-S.7017
                6179077
                29350643
                5281b666-fef1-4cb5-b158-c5a8cd86663b
                Copyright: © 2018 ACTA BIO MEDICA SOCIETY OF MEDICINE AND NATURAL SCIENCES OF PARMA

                This work is licensed under a Creative Commons Attribution 4.0 International License

                History
                : 15 September 2017
                : 20 December 2017
                Categories
                Review

                trauma,trauma imaging,calcaneal fractures,conventional x-ray,computed tomography,ct

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