Is Subclassification by Number of Fracture Fragments Necessary for Sanders Type IV Calcaneal Fractures?

IF 0.5 4区医学 Q4 ORTHOPEDICS

Journal of the American Podiatric Medical Association Pub Date : 2023-11-01 DOI:10.7547/21-135

Dong-Hee Kim, Jhee-Yun Kim, Kwang-Bok Lee

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引用次数: 0

Abstract

Background: The Sanders classification is a widely used method for classifying calcaneal fractures. Type IV fractures (>4 fragments) are known to vary in the number of fracture fragments. However, all relevant cases are classified as type IV irrespective of the number of fragments. We investigated the need for evaluation of postoperative prognoses based on radiologic factors and subtypes of Sanders classification type IV fractures.

Methods: Fifty-six Sanders type IV calcaneal fractures were enrolled between 2010 and 2018. Patients were divided into two groups according to the number of fragments: four fragments (group 1) and more than four fragments (group 2). Radiologic evaluation was performed using a postoperative recovery percentage calculated from postoperative reduction of the Böhler angle, Gissane angle, and vertical height. Radiologic evaluation was divided into two groups according to postoperative recovery: good and bad recovery groups. American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score and visual analog scale (VAS) score were used for clinical outcome evaluation.

Results: There was no significant difference in AOFAS ankle-hindfoot score (P = .909) or VAS score (P = .963) between groups 1 and 2. However, there was a significant (P = .001) difference in AOFAS ankle-hindfoot score or VAS score between good and bad recovery groups.

Conclusions: Clinical results of Sanders type IV fractures were not related to the number of bone fragments but to the degree of injury to the Böhler angle, Gissane angle, and vertical height. Therefore, subtype classification of type IV calcaneal fractures is superfluous, and it is important to try to restore these parameters during surgery.

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桑德斯 IV 型钙骨骨折是否有必要按骨折片数量进行子分类？

背景：桑德斯分类法是一种广泛使用的方骨骨折分类方法。众所周知，IV 型骨折（>4 个骨折片）的骨折片数量各不相同。然而，所有相关病例无论骨折片数量多少都被归类为 IV 型。我们研究了根据放射学因素和桑德斯分类 IV 型骨折亚型评估术后预后的必要性：2010 年至 2018 年间，我们共纳入了 56 例 Sanders IV 型小腿骨骨折患者。根据骨折片的数量将患者分为两组：4片（第1组）和4片以上（第2组）。根据术后波勒角、Gissane角和垂直高度的缩小情况计算术后恢复百分比，进行放射学评估。根据术后恢复情况将放射学评估分为两组：恢复良好组和恢复不良组。临床结果评估采用美国骨科足踝协会（AOFAS）踝关节-后足评分和视觉模拟量表（VAS）评分：第一组和第二组的 AOFAS 踝关节-后足评分（P = .909）或 VAS 评分（P = .963）无明显差异。然而，恢复良好组和恢复不良组的 AOFAS 踝关节-后足评分或 VAS 评分有明显差异（P = .001）：结论：Sanders IV型骨折的临床结果与骨碎片的数量无关，而是与Böhler角、Gissane角和垂直高度的损伤程度有关。因此，IV型小腿骨骨折的亚型分类是多余的，重要的是在手术中尽量恢复这些参数。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of the American Podiatric Medical Association 医学-整形外科

CiteScore

1.10

自引率

0.00%

发文量

128

审稿时长

6-12 weeks

期刊介绍： The Journal of the American Podiatric Medical Association, the official journal of the Association, is the oldest and most frequently cited peer-reviewed journal in the profession of foot and ankle medicine. Founded in 1907 and appearing 6 times per year, it publishes research studies, case reports, literature reviews, special communications, clinical correspondence, letters to the editor, book reviews, and various other types of submissions. The Journal is included in major indexing and abstracting services for biomedical literature.