RESUMEN
93 patients with 102 intraarticular calcaneus fractures (ICF) were examined by CT from 1986 to 1992. The images were evaluated with the use of a modified classification based on the number of fractured heel bone facets (2 facets in 4.8%, 3 facets in 53.9%, 4 facets in 32.3%, comminution in 8.8% of the fractures), the involvement of the calcaneus-cuboid joint (60.8%) and the fracture mechanism (tongue-type in 28.4%, joint depression in 62.7%) with the weight-bearing calcaneal compartments taken into special consideration. In that way, each intraarticular calcaneus fracture could be scored, enabling a fast diagnosis comprising factors relevant for the therapy and prognosis.
Asunto(s)
Calcáneo/diagnóstico por imagen , Calcáneo/lesiones , Fracturas Óseas/clasificación , Fracturas Óseas/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Adolescente , Adulto , Anciano , Femenino , Fracturas Óseas/epidemiología , Alemania Occidental/epidemiología , Humanos , Masculino , Persona de Mediana Edad , Pronóstico , Estudios Retrospectivos , Tomografía Computarizada por Rayos X/métodosRESUMEN
A prospective, arthroscopic controlled study was performed to evaluate the usefulness of mancal sonometry of the knee in the diagnosis of acute rupture of the anterior cruciate ligament (ACL). In 58 patients with an acute knee injury, a maximum of 30 days elapsed between accident and clinical examination (Lachmantest, pivot-shift/ McIntosh, 90 degrees anterior translation), manual sonometry and functional X-ray examination. Afterwards all patients were examined by arthroscopy. Nine patients showed a partial, 38 patients a total rupture of the ACL. If the ACL was completely ruptured, the average difference in anterior translation between the contralateral and the injured knee was 3.3 mm (p < or = 0.001). Statistical analysis showed high sensitivity (85%), specificity (91%) and positive predictive value (98%) for manual sonometry. Clinical examination, apparative sonometry and functional X-ray were, overall, less effective than manual sonometry in detecting ligament rupture. Manual sonometry proved to be a good and practicable method for assessing acute rupture of the ACL.