Thossart HARNROONGROJ, Thos HARNROONGROJ, Thongchai SUNTHARAPA, Marut ARUNAKUL

The new intra-articular calcaneal fracture classiŞcation system in term of sustentacular fragment conŞgurations and incorporation of posterior calcaneal facet fractures with fracture components of the calcaneal body

Objective: The aim of this study was to develop a new calcaneal fracture classiŞcation system which willconsider sustentacular fragment conŞguration and relation of posterior calcaneal facet to calcaneal body.Methods: The new classiŞcation system used sustentacular fragment conŞguration and relation ofposterior calcaneal facet fracture with fracture components of calcaneal body as key aspects of maintypes and subtypes. Between 2000 and 2014, 126 intraarticular calcaneal fractures were classiŞed according to the new classiŞcation system by using computed tomography images. The new classiŞcationsystem was studied in term of reliability, correlation to choices of treatment, implantŞxation and qualityof fracture reduction.Results: Types of sustentacular fragment comprised type A, B and C. Type A sustentacular fragmentincluded sustentacular tali containing middle calcaneal facet. In Type B and C fractures sustentacularfragment included medial aspect and entire posterior calcaneal facet as a single unit, respectively. Thefractures with type A, B and C sustentacular fragments were classiŞed as main type A, B and C intraarticular calcaneal fractures. The main type A and B comprised 4 subtypes. Subtypes A1, A3, B1, andB3 associated with avulsion and bending fragments of calcaneal body. Subtype A2, B2, and B4 associatedwith burst calcaneal body. Subtype B4 was not found in the study. Main type C had no subtype andassociated with burst calcaneal body. The data showed good reliability.Conclusion: The study showed that our new intra-articular calcaneal fracture classiŞcation system correlates to choices of treatment, implantŞxation and quality of fracture reduction.Level of Evidence: Level IV, Study of Diagnostic Test© 2016 Turkish Association of Orthopaedics and Traumatology. Publishing services by Elsevier B.V. This isan open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

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