The Journal of Bone and Joint Surgery, Vol 72, Issue 6 852-859, Copyright © 1990 by Journal of Bone and Joint Surgery, Inc
Computerized tomography scanning of acute intra-articular fractures of the calcaneus. A new classification system
LA Crosby and T Fitzgibbons
Division of Orthopaedic Surgery, Creighton University School of Medicine, Omaha, Nebraska 68131.
Computerized tomography was used to evaluate thirty intra-articular
fractures of the calcaneus in twenty-seven patients. A classification of
the fractures was devised on the basis of fracture patterns involving the
posterior facet joint of the calcaneus. In Type I, the fracture fragments
were small or not displaced; in Type II, they were displaced; and in Type
III, they were comminuted. There were thirteen Type-I, ten Type-II, and
seven Type-III fractures, all of which were treated with a variety of
closed methods. The length of follow-up ranged from eighteen to fifty-two
months (mean, thirty-six months). The results were graded by a
predetermined point system that included the evaluation of motion of the
subtalar joint. Of the thirteen Type-I fractures, eight had an excellent
result; four, a good result; and one, a fair result. Of the ten Type-II
fractures, two had a good result; four, a fair result; and four, a poor
result. All of the seven Type-III fractures had a poor result. On the basis
of our study of the fracture patterns as seen on the computerized
tomography scans, we believe that it is possible to predict which fractures
will do well with closed treatment and which will not. Type-I fractures did
well with closed treatment. Type-II fractures can be treated closed but
with a lower success rate than Type-I fractures. All of the Type-III
fractures had a poor result after closed treatment.
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