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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