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MINERVA ORTOPEDICA E TRAUMATOLOGICA
A Journal on Orthopedics and Traumatology
Minerva Ortopedica e Traumatologica 2000 December;51(6):345-54
Imaging of calcaneus fractures
Garlaschi G., Verrina F., Orengo G., D'Avanzo S., Claudiani V., Silvestri E.
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Calcaneus fractures are generally divided into intra-articular (25%) and extra-articular (75%) and produced by impact of the heel with the ground. These fractures are often comminuted and the bone fragments may be compressed in cranio-caudal direction as well as displaced medially or laterally. Imaging gives a very important contribution for a correct clinical diagnosis. Plain film is a good technique in evaluation of acute injuries and in post-traumatic results. CT is directly performed in axial and coronal planes and it is reconstructed in sagittal scan and 3D imaging. This technique can provide information regarding number, size and location of each fracture fragments and gives an approximate evaluation of severity of articular injuries. MRI is less useful than CT in acute injuries since bone changes are covered by edema and hemorrhagia; it has instead proved to be more sensitive in identifying post-traumatic changes. MRI is able to well define soft tissue, cartilage and bone. The introduction of low field unit has promoted the widespread of MRI examination in the study of calcaneus fractures. We use other techniques (US and SCINTIGRAPHY) only in selected cases, particularly in post-traumatic studies.