CT Measurement of the Calcaneal varus Angle in the Normal and Fractured Hindfoot

Richardson, Michael L.; Vu, Michael Van; Vincent, Logan; Sangeorzan, Bruce J.; Benirschke, Stephen K.

doi:10.1097/00004728-199203000-00015

Cited by 29 publications

(38 citation statements)

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“…The only reported study on Nigerians, however, also using similar methods, showed a range of 28 -38°, an indication of regional variation amongst African subjects as well as ethnic variation between Africans and Caucasians. This is an interesting finding as the calcaneal angle is used by orthopedic surgeons to assess calcaneal fracture, and is considered in the operative management of such fractures (Richardson et al, 1992;Loucks and Buckley, 1999). This reinforces the need for this angle to be widely measured to establish standards for different countries in the African sub-region.…”

Section: Discussionmentioning

confidence: 72%

Calcaneal angle in Ugandans

Igbigbi

Mutesasira

2003

Clinical Anatomy

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We investigated the calcaneal angle from 206 unilateral radiographs of the lateral aspect of the foot in Ugandans, comprising 114 males and 92 females, aged 20-40 years. The mean angle in males was 35.1 degrees with a standard deviation (SD) of 7.5 degrees and, in females, 37.6 degrees with SD 5.6 degrees. The range of the angle for both sexes together was 20-50 degrees with females having a significantly higher mean value than males (P < 0.01). There was also a significant difference in the angle between Ugandan and Nigerian men (P < 0.01) and between Ugandan and Nigerian women (P < 0.001). Our reported range was the widest so far documented in Africans. Our study reinforces the need to establish the normal range of the angle in a given population and also highlights the clinical importance of the angle to orthopedic surgeons managing calcaneal fractures in this part of the world.

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Section: Discussionmentioning

confidence: 72%

Calcaneal angle in Ugandans

Igbigbi

Mutesasira

2003

Clinical Anatomy

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“…A decision has to be made only concerning the presence or absence of a varus or valgus shift from the normal value (approximately 25°). With regard to the calcaneocuboid angle with fractures of the calcaneus, Richardson et al showed the importance of deviations from healthy calcaneal proportions [20]. In addition to this classification, assessment for an axis shift of the sagittal talocalcaneal axis and shortening of the calcaneal length help to improve preoperative planning and are appreciated by orthopedic surgeons.…”

Section: Discussionmentioning

confidence: 99%

“…Conventional radiographs are taken mediolaterally and axially. Additional projections are seldom useful, but CT is considered the routine procedure for diagnosis [2,3,4,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23].…”

Section: Introductionmentioning

confidence: 99%

Classification of calcaneal fractures by spiral computed tomography: implications for surgical treatment

et al. 2003

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The purpose of this study was to evaluate spiral computed tomography and multislice CT (SCT/MSCT) with multiplanar reconstructions (MPR) in the classification of calcaneal fractures according to a modified CT classification and to quantify fragment displacement to guide surgical treatment. Forty-eight calcaneal fractures were examined by spiral CT (1- to 2-mm slice thickness, pitch=1.5) with multiplanar reconstructions (MPR). Fractures were grouped according to a modified Munich classification scheme, differentiating six categories of fractures by joint involvement, number of fragments in the posterior facet, and the presence and extent of displacement. A qualitative and quantitative statement was made for the presence of clinical relevant displacement of the posterior articular facet (A: >2 mm), widening of the heel (B: crossing fibular reference line), reduction in calcaneal height (C: >10%), and axis shift of the calcaneocuboid angle (D: >10 degrees ). Treatment recommendations resulting from the CT classification were retrospectively compared with the treatment given by examining the patients' files. There were 10 extra-articular and 38 intra-articular fractures; 8 were in class I (extra-articular, nondisplaced), 2 in class II (extra-articular, displaced), 1 in class III (intra-articular, nondisplaced), 20 in class IV (two fragments), 9 in class V (three fragments), and 8 in class VI (>4 fragments), one of the latter being uncertain; 34 showed displacement of the articular facet, 35 widening of the heel, 35 reduction in calcaneal height, and 20 a shift of the axis. In 94% of the cases the procedure recommended by the Munich system of classification was followed; there was disagreement in 1 case in class I and 1 in class IV. Spiral CT allowed fracture classification and quantification of relevant displacement of fragments by radiologists. The implemented recommendations for treatment were adopted by surgeons in most cases.

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“…Computed tomography (CT) has proven to be superior to conventional X-rays in the evaluation of calcaneal fractures, affording optimal anatomical assessment in the axial and coronal planes [10][11][12][13][14][15][16][17][18]. CT scanning is thus to be considered today mandatory as choice technique for comprehensive pre-and post-operative imaging of the fractures site [11,14,15].…”

Section: Introductionmentioning

confidence: 99%

“…CT scanning is thus to be considered today mandatory as choice technique for comprehensive pre-and post-operative imaging of the fractures site [11,14,15].…”

Section: Introductionmentioning

confidence: 99%

Association between CT imaging at follow-up and clinical outcomes in heel fractures

et al. 2010

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The reliability of CT data for calcaneal fractures was evaluated, quantifying five CT parameters and investigating their association with clinical outcomes. Fifty-four intra-articular calcaneal fractures surgically treated were considered. Vertical and longitudinal alignment, calcaneal body height, position of sustentaculum tali and subtalar joint congruity were evaluated at 49 months (27-94) follow-up. Each parameter was then quantified and its association with the clinical outcome assessed by the Maryland Foot Score was evaluated. Better clinical outcomes showed a significant association with vertical/longitudinal realignment and with restoration of the calcaneal height. No significant association emerged with reconstruction of the thalamic joint facet congruity. Three-dimensional reconstruction of the calcaneus, in terms of vertical and longitudinal alignment, restoration of the height of the heel body even irrespective of a perfect joint congruity, seems today to be the main goal of the treatment.

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CT Measurement of the Calcaneal varus Angle in the Normal and Fractured Hindfoot

Cited by 29 publications

References 0 publications

Calcaneal angle in Ugandans

Calcaneal angle in Ugandans

Classification of calcaneal fractures by spiral computed tomography: implications for surgical treatment

Association between CT imaging at follow-up and clinical outcomes in heel fractures

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