Postoperative Evaluation of Displaced Intra-articular Calcaneal Fractures by Computed Tomography

PURPOSE: The purpose of the present study was to define the factors that affect the treatment and clinical result of displaced calcaneal fracture with use of the pre- operative and final follow-up computed tomography scanning. MATERIALS AND METHODS: Present study included the 17 patients(18 feet) whom we performed surgery for displaced intra-articular calcaneal fracture at our institution between March 2000 and March 2002 and had a minimum follow-up of 12 months. For all patients, the Bohler's angle and posterior facet incongruity were measured with computed tomography pre- and post-operatively. The Creighton-Nebraska Health Foundation Assessment Scale for Fractures of the Calcaneus (CN scale) was used to evaluate the clinical results. RESULTS: Of all eighteen fractures, the clinical results were excellent in three (16.6%), good in six (33.3%), fair in six (33.3%), and poor in three (16.6%). The Bohler's angle averaged 21degrees, 15degrees, 27degrees, 25degrees at final follow-up in each above clinical result group. The step-off averaged 1.0, 1.6, 3.9 and 6.0 mm and the average range of motion of the subtalar joint at final follow-up were 85, 76, 60 and 45% of normal. CT evaluation showed intra-articular screws in the posterior subtalar joint in three (16.6%) of the eighteen fractures but their average clinical result was good (80.3 points). CONCLUSION: The restoration of the congruity and range of motion of posterior subtalar joint are considered important factor that affect clinical result.