Does the addition of computed tomography to computed radiography provide more value to final outcomes and treatment decisions in displaced intra-articular calcaneal fractures?

Abstract

© 2014, Medical Association of Thailand. All Rights Reserved. Background: Little is known about the additional prognostic value of computed tomography (CT) in addition to computed radiography in displaced intra-articular calcaneal fractures. The present study was undertaken to examine and compare the final radiographic outcomes and the prevalence of treatment methods of displaced intra-articular calcaneal fractures in patients with preoperative computed radiography alone vs. a combination of computed radiography and computed tomography. Material and Method: Thirty-four patients with 38 displaced intra-articular calcaneal fractures were divided into two groups: a group that was evaluated with computed tomography and computed radiography (17 patients; 20 fractures) and a group that was evaluated with computed radiography alone (17 patients; 18 fractures). Patient demographics, preoperative and postoperative Bohler’s angles, and fracture classifications were recorded. Postoperative outcomes were evaluated using calcaneal fracture radiographic scores (modified Zwipp score). Results: The mean age of our patients in the present study was 43.3±12.3 years. The mean age of the patients in the computed tomography group (48.4±11.6 years) was significantly higher than that of the non-computed tomography group (37.6±10.7 years, p = 0.005). The mean follow-up time was 17.4±9.8 months. There was a significantly higher prevalence of open reduction and internal fixation in the computed tomography group versus the non-computed tomography group (p = 0.019). However, there was no significant difference observed for the mean radiographic scores. Postoperatively, outcomes were satisfactory in both groups, although intra-articular alignment was significantly better in the computed tomography group (p = 0.020). Conclusion: The overall outcomes were comparable between the patient groups with computed tomography vs. those without computed tomography, except for the superiority of postoperative intra-articular alignment in patients with computed tomography. Open reduction and internal fixation were more frequently performed in the patients with computed tomography than patients without computed tomography.