BACKGROUND: To compare the effectiveness of intraoperative three-dimensional (3D) image and conventional two-dimensional (2D) fluoroscopic images, which are used in the treatment of acute calcaneal fractures. METHODS: We retrospectively analyzed 40 patients who suffered calcaneal fracture and underwent surgery at Inje University Busan Paik Hospital. The patients were divided into two groups. Only 2D fluoroscopy was used to evaluate 20 patients of group 1. On the other hand, 3D fluoroscopy was performed on the remaining 20 patients of group 2; 3D fluoroscopy was performed on these patients after they were extensively evaluated by 2D fluoroscopy during surgery. We reviewed the radiographic and clinical outcomes of these patients, whose average follow-up period was 42.6 months. RESULTS: In group 2, 3D fluoroscopy detected four cases (20%) of articular incongruence and screw misplacement. All these complicated cases were corrected during surgery. At the final follow-up session, the mean American Orthopedic Foot and Ankle Society (AOFAS) hind foot score was 78.3 (range, 65 to 95) in group 1 and 82.3 (range, 68 to 95) in group 2. CONCLUSIONS: Intraoperative 3D imaging of calcaneal fractures is considered to be useful in evaluating the congruence of joints and the placement of implants.
Adult ; Calcaneus/*injuries/radiography/*surgery ; Female ; Fluoroscopy ; Fracture Fixation, Internal/*methods ; Fractures, Bone/radiography/*surgery ; Humans ; Imaging, Three-Dimensional/*methods ; Male ; Middle Aged ; Operative Time ; Young Adult

Adult ; Calcaneus ; injuries ; surgery ; Female ; Fracture Fixation, Internal ; methods ; Fractures, Bone ; diagnostic imaging ; surgery ; Humans ; Male ; Middle Aged ; Radiography ; Treatment Outcome ; Young Adult

OBJECTIVETo design a kind of adjustable triangle external fixator, and to use it for treating calcaneal fractures.

METHODSThe external fixator was installed into extremity near the both sides of three Kirschner wires crossing the calcaneal tubercle, the lower end of the tibia and the first cuneiform. The support rod length was adjusted to ensure the Kirschner wires affecting the calcaneal tubercle, so the Böhler angle and anteroposterior diameter of the calcaneus were recovered. From April in 2003 to April in 2008, the external fixators were used to treat 34 patients with calcaneal fractures, including 30 males and 4 females, ranging in age from 19 to 54 years, with an average of 36.7 years. The Böhler angles were -5 degree to 15 degree, with an average of 13.5 degrees. According to Sander's classification, 2 patients were type II, 20 patients were type III, and 12 patients were type IV.

RESULTSThirty-four patients were followed up, and the duration ranged from 3 months to 4 years, averaged 25 months. The Böhler angle recovered to 30 degree to 40 degrees, with a mean of 32.5 degrees. The Maryland mean score improved from preoperative (24.76+/-15.05) to postoperative (83.26+/-16.81). Based on Maryland criteria, 8 patients got an excellent result, 21 good, 3 fair and 2 bad.

CONCLUSIONThe adjustable triangle external fixator for treating calcaneal fractures has the following advantages : simple approach, good recovery, little reinjury and complications, effectiveness to recovery Böhler angle and anteroposterior diameter of calcaneal, which is an ideal method to treat calcaneal fractures.

Adult ; Calcaneus ; diagnostic imaging ; injuries ; surgery ; External Fixators ; Female ; Fractures, Bone ; diagnostic imaging ; surgery ; Humans ; Male ; Middle Aged ; Models, Theoretical ; Radiography ; Treatment Outcome ; Young Adult

OBJECTIVETo evaluate the results of intra-articular calcaneal fractures treated with open reduction and internal fixation.

METHODSThirty-five displaced intra-articular calcaneal fractures in 34 patients were treated with open reduction and internal fixation from August 2001 to April 2003. Fracture classification was based on Sanders classification. Extended lateral approach, and fixed the fractures with AO titanium plate for calcaneus were performed. Bone graft was used in selected patients. Thirty-five fractures in thirty-four patients were evaluated using radiographic examinations and ankle hindfoot clinical rating system of the American Orthopaedic Foot and Ankle Society (AOFAS). Average follow-up was 18.3 months (range from 12 to 32 months).

RESULTSThere were 30 type II fractures and 5 type III fractures. Average Böhler's angle was 5.6 degrees preoperatively and 28.2 degrees finally. Roentgenographic evaluation of calcaneal body dimensions showed restoration of heel height (97.7%) to virtually normal. Anatomic or near anatomic reductions were obtained in 80% of the cases. The average score was 88.1 for type II fractures, and 78.8 for type III fractures. Excellent or good clinical results occurred in 82.8% type II fractures, and 60.0% type III fractures. The overall excellent or good rate was 79.4%.

CONCLUSIONFrom the results, open reduction and internal fixation for Sanders type II and type III fractures are recommended.

Adult ; Calcaneus ; diagnostic imaging ; injuries ; surgery ; Female ; Follow-Up Studies ; Fracture Fixation, Internal ; adverse effects ; methods ; Fractures, Bone ; diagnostic imaging ; surgery ; Humans ; Male ; Middle Aged ; Radiography ; Treatment Outcome

Ankle Injuries ; diagnostic imaging ; surgery ; Bone Cements ; Calcaneus ; diagnostic imaging ; injuries ; surgery ; Calcium Phosphates ; Fracture Fixation, Internal ; methods ; Fractures, Bone ; diagnostic imaging ; surgery ; Humans ; Prospective Studies ; Radiography ; Treatment Outcome