Monitoring Of Broden View X-ray Examination And Treatment Of Calcaneal Intra-articular Fracture

Objective To research the value of clinical application of calcaneal intra-articular fracture and improve its levelof treatment.Methods All of 47 feet of calcaneal intra-articular fracture were examinated by lateral and axial x-ray, 21 cases of all by routine CT, and 4 cases of all by spiral CT. According to Sanders fracture classification: there are 4 feet of I type, 10 of Sanders II , 28 of Sanders Ⅲ, 5 of Sanders IV . 22 feet of 16 cases of serious fracture were examitnated by Broden view x-ray before operation, and were finished reduction of articular surface with monitoring of Broden view x-ray of "C" arm machine during operation. Meanwhile to summarizes experience of treatment of 36 cases of calcaneal fracture from 1998.9~2004.12 in our hospital.Results All cases were followed up for 2 ~ 56 months, average 16.8 months. According to Maryland' s classification, all of 47 feet, excellent rate is 100% in Sanders I type fracture; excellent rate is 90% in Sanders II type fracture; excellent rate is 85.7% in Sanders Ⅲ type; excellent rate is 60% in SandersIV type; all excellent rate is 85. 1%.Conclusion ①It is necessary to perfect examination of iconography: lateral and axial x-ray of film calcaneous; Broden view x-ray film; CT or spiral CT. ② Advice of treatment: Sanders I type: close-plaster and premature dirigation; Sanders II type:operate limited internal fixation with Kirschner pins or recontruction plates; Sanders Ⅲ— Ⅳ type: make secure limited internal fixation with calcaneal anatomy plate and ilium (or artifical bone). The old agedmen , type HI calcaneal fracture patients with serious osteoporotic and Type IV calcaneal fracture without anatomical restoration of the posterior facet make warrant subtalar arthrodesis ; ?Open recton not only reconstruct thesutalar joint and anatomic reduction, but also restore the hindfootarchitecture. It was an effectual device for treatment of calcaneal fracture with illustration of Broden view X-ray examination; (4) It is the key to make reasonable choice of surgical approaches and timing, to evaluate the detail of joint surface involved,and to achieve good reduction and internal fixation.