Diagnosis and classification of calcaneal fractures in computed tomography

Herold, Thomas and Folwaczny, E. K. and Stuermer, K. M. and Grabbe, E. and Funke, M. (2004) Diagnosis and classification of calcaneal fractures in computed tomography. ROFO-FORTSCHRITTE AUF DEM GEBIET DER RONTGENSTRAHLEN UND DER BILDGEBENDEN VERFAHREN, 176 (9). pp. 1271-1277. ISSN 1438-9029,

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Abstract

Purpose: To compare image quality of single-slice spiral CT (SSCT) and multislice spiral CT (MSCT) in the diagnosis and classification of calcaneal fractures and to present a rapid and precise algorithm for the classification system of Stuermer. Materials and Methods: In 102 patients with 124 calcaneal fractures, spiral CT was performed, in 82 cases as SSCT with a slice thickness (SD) of 3 mm, a table speed (TS) of 3 - 4 mm/rot and an increment of 1.5 mm. In 42 cases, patients were scanned using MSCT (SD of 1.25 mm, increment 0.8 mm). For these examinations, 2 different scan protocols were used, with a TS of 3.75 mm/rot in one group (n = 21) and a TS of 7.5 mm/rot in the other group (n = 21). The image quality of axial sections and reconstructed images was assessed on a scale from I to 5 (1 = very good; 5 = insufficient). The fractures were evaluated using a classification system according to Stuermer, which assigns three main groups (A/B/C) and three subtypes (1/2/3). Results: MSCT had substantial advantages over SSCT with respect to scan time and image quality, especially for multiplanar reformatting (median 1.5 versus 4.0). TS showed no significant influence on the image quality. The standardized evaluation of the images enabled a classification of fractures within 5 minutes. All fractures could be assigned to the different types and subtypes. This classification system takes into account the severity of the fracture and the therapeutic approach. The most common type (90 of 124 fractures) were "joint depression" fractures (type C), which were treated by surgery in 92%. Type A fractures were treated conservatively in 72%. Conclusion: Spiral CT, especially MSCT, allows rapid diagnosis and precise classification of calcaneal fractures, achieved with high quality multiplanar reformatting. The presented classification in different fracture types and subtypes allows an adequate planning of therapy.

Item Type: Article
Uncontrolled Keywords: INTRAARTICULAR FRACTURES; OPEN REDUCTION; INTERNAL-FIXATION; CT; ANATOMY; OSTEOSYNTHESIS; Computed Tomography (CT); helical computed tomography; multislice computed tomography; calcaneus; calcaneus fractures
Subjects: 600 Technology > 610 Medical sciences Medicine
Divisions: Medicine > Lehrstuhl für Unfallchirurgie
Medicine > Lehrstuhl für Röntgendiagnostik
Depositing User: Dr. Gernot Deinzer
Date Deposited: 30 Jun 2021 09:29
Last Modified: 30 Jun 2021 09:29
URI: https://pred.uni-regensburg.de/id/eprint/37301

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