THE ROLE OF MULTI DETECTOR CT IN ASSESMENT OF CALCANEAL FRACTURES AND ITS VALUE IN DETERMINING MANAGEMENT PLAN

Abstract

MDCT allows better visualization of fracture lines, dislocation, and comminution of calcaneal fractures, especially intraarticular fractures. Involvement of the posterior facet of the subtalar joint is used to identify fracture type according to the Sanders classification system for intra articular fractures, which represent the majority of calcaneal fractures. The Sanders system has proved useful, having been shown to correlate with management and prognosis, without significant interobserver variability. Extra articular fractures include all fractures that do not involve the posterior facet, and they are classified on the basis of their anatomic location on the anterior process, body, or posterior tuberosity of the calcaneus. Bohler’s angle is an important parameter in the assessment and diagnosis of the Calcaneal fracture, It normally measures between 20o and 40o degrees, if an angle of Bohler less than 20° this indicates posterior facet collapse from an underlying calcaneal fracture. Fracture calcaneus occasionally extends anteriorly to the calcaneocuboid joint, CT images allowed to assess the degree of calcaneocuboid joint involvement before surgery. Radiologists must be familiar with injuries of the calcaneus, their anatomy, mechanisms, classification, and implications to help guide the treating physicians.