전산화 단층촬영을 이용한 종골 관절내 골절의 분류 및 치료 결과 판정

Abstract

The calcaneal fractures, the most common tarsal bone fracture are one of the difficult fractures in diagnosis and treatment because of its anatomic complexity and fracture pattern. The authors had taken pre-operative computed tomographies(CTs) and plain X-rays on calcaneal fractures prospectively since March 1992 and the calcaneal fractures were classified according to fracture patterns and locations. Twenty nine fracture were treated with open reduction and internal fixation. Following open reduction and internal fixation of displaced fractures mostly involving posterior facet of subtalar joint or closed reduction with axial pinning by Essex-Lopresti method, we have taken CT on 32 fractures and analyzed anatomic status and observed the relationship between anatomic status and clinical results. The results were as follows: 1. According to Sanders classification, type Ⅱ was the most common(69%), and then type Ⅲ(22%), type Ⅳ(6%), type Ⅰ(3%) in frequently. 2. In the relationship between preoperative CT classification and postoperative reduction state, reduction state was in case of more communication. 3. We can expect excellent or good result when the postoperative displacement is within 2mm. 4. The Sanders classification appears to be helpful in predicting prognosis since preoperative CT significantly influenced the clinical outcome, as noted in the relationship between preoperative CT and clinical results.