Journal of Musculoskeletal Trauma

The Radiologic Evaluation of Treatment Outcome in Intra-articular Calcaneal Fracture by Open Reduction without Bone Graft: Kwang Soon Song, Si Hyun Jeon, Jae Hong Chun; J Korean Soc Fract 2002;15(2):226-233. Published online April 30, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.2.226

PURPOSE
The purpose of this study was to investigate the efficacy of bone graft use in the treatment of displaced intra-articular calcaneal fractures.
MATERIALS AND METHODS
We analysed retrospectively 40 displaced intra-articular calcaneal fractures, which had undergone open reduction and internal fixation without bone graft from June 1989 to July 1998. Radiological assessments were made from the lateral view of the affected calcaneus, recording the Bohler angle, the Gissane angle and ratio of height/width of the calcaneus. Matching criteria included Essex-Lopresti classification, method of fixation, age, and sex.
RESULT
The mean preoperative Bohler angle was -7 degrees(standard deviation [S D ] 1 8 degrees), postoperative Bohler angle was 21 degrees(SD 7 degrees), last follow-up Bohler angle was 1 9 degrees(SD 7 degrees). Bohler angle increased a mean 28 degrees(maximum 70 degrees, minimum 2 degrees). The preoperative Gissane angle was 104 degrees(SD 17.87 degrees), postoperative Gissane angle was 1 0 6 . 2 degrees(SD 10.07 degrees), last follow-up Gissane angle was 104.48 degrees(SD 10.1 degrees). The preoperative ratio of height/width of the calcaneus was 0.568(SD 0.076), postoperative ratio was 0.637(SD 0.037), last follow-up ratio was 0.648(SD 0.038). There was no significant differences in fracture pattern, method of fixation, age, and sex(P>0.05).
CONCLUSION
The result of this study showed that there was no significant change in serial radiologic evaluation. Bone graft was not served to the effectiveness or security in the treatment of displaced intra-articular calcaneal fractures.

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Open Reduction and Internal Fixation with AO Calcaneal Plate for Displaced Intra-articular Calcaneal Fracture
Myung Jin Lee, Sung Keun Sohn, Kyu Yeol Lee, Sung Soo Kim, Min Soo Kang, Hyeon Jun Kim, Sang Kyu Sun
Journal of the Korean Fracture Society.2010; 23(3): 303. CrossRef

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The Classiflcation and Management of Intraarticular Calcaneal Fracture Based on Computed Tomography: Jae lk Shim, Taik Seon Kim, Sung Jong Lee, Suck Ha Lee, Chang Moo You, Young Bae Kim; J Korean Soc Fract 1996;9(3):742-749. Published online July 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.3.742

Abstract PDF

Displaced intraarticular fractures of the calaneus require operative intervention to restore the anatomy of the bone, which in turn is the requirement for recovery of subtalar joint mobility. To evaluate the complex contour of calcaneal anatomy, a classification for intraarticular calcaneal fractures was used, based on standardized coronal and transverse computed tomography scans of os calsis. From January 1993 to December 1994, intraarticular calcaneal fractures of 47 cases treated in Korea Veterans Hospital were analysed preoperatively with C.T. scan and classified by Sandersclassification system. And clinical evaluation of the patients was done by Maryland Foot Score postoperatively. The result were as follows:Type I fractures were found in 10 cases. 25 cases of 47 cases were classified as type II and subdivided as II A in 13 cases, II B in 6 cases, II C in 6 cases. Type III fractures were found in 8 cases and subdivied as III AB in 4 cases, III BC in 3 cases, III AC in 1 case. Type IV fractures were found in 4 cases. This classification aids a surgeon to make perioperative decision, because it has prognostic significance.

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Surgical Outcome of Stable Scaphoid Nonunion without Bone Graft
Eun Sun Moon, Myung Sun Kim, Il Kyu Kong, Min Sun Choi
Journal of the Korean Fracture Society.2010; 23(1): 69. CrossRef
The Comparison of Radiographic Parameters and Clinical Results after Operative Treatment of Displaced Intraarticular Calcaneal Fractures
Hong Moon Sohn, Jun Young Lee, Sang Ho Ha, Sueng Hwan Jo
Journal of the Korean Fracture Society.2007; 20(3): 227. CrossRef

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Operative Treatment of Intra-articular Calcaneal Fractures by Posterior Approaeh: Youn Soo Kim, Ckoong Seo Park, In Tak Chu, Hyoung Min Kim, Jae Duk Ryu; J Korean Soc Fract 1992;5(2):191-198. Published online November 30, 1992; DOI: https://doi.org/10.12671/jksf.1992.5.2.191

Abstract PDF: In contrast to the extra-articular calcaneal fractures, the treatment of intra-articular fractures is very difficult and the final result is not always satisfactory, because it has not only difficulties in the identification of the exact fracture pattern and an anatomical reduction of the fracture fragments, but also no principle of ideal treatment. Today, numerous controversies remain regarding the treatment of intra-articular calcaneal fractures, which include the need of reduction, the method of reduction, the surgical approach. the method of fixation, and the need of bone graft. We propose the posterior approach and longitudinal buttress screw fixation for the treatment of intra-articular calcaneal fractures. The posterior approach allows excellent visualization of the posterior facet of subtalar joint, and the longitudinal screw buttresses the posterior facrt fracture fragment of calcaneus. From Dec. 1990 to May 1992, 17 intra-articular calcaneal fractures out of 15 patients were treated by our surgical method and followed up (average, 9.2 months) in 12 cases out of 10 patients (2 bilateral cases). Seven cases were tongue type fractures and five were joint do- pression type. Operations were performed 5 to 15 days after accident(average, 92 days). Bone graft was performed only 3 cases. At last follow-up, there was no pain in 8 cases. intermittant dull pain in 3, and resting pain in 1. The Bohlers angle at post-accident and last follow-up were 5.9 and 30.7 in tongue type : 10.6 and 32.6 in joint depression type. The reduction of the fracturr fragments was maintained well and secondary deformities were not developed in all cases. Based on these findings in this study, most of the intra-articular calcaneal fractures can be reduced anatomically by posterior approach, and fracture fragment maintained by longitudinal buttress screw fixation.

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