An Audit of the CT Scan Radiological Reporting System in Calcaneal Fractures at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH)

Abstract

INTRODUCTION: Calcaneus fractures account for 1-2% of fractures. The Sanders classification system is the most used to classify intra-articular calcaneal fractures using computed tomography (CT). AIM: To monitor the use of the Sanders classification of calcaneal fractures and thus determine the most common type of Sanders classification reported. To assess the presence of concomitant fractures in the foot and ankle. To ascertain the prevalence of calcaneal fractures and to assess the standard of the radiology reporting system in the diagnosis. METHOD: This was a retrospective review of radiology reports in trauma patients with foot and ankle imaging at a Johannesburg based academic hospital between January 2018 and December 2019. RESULTS: There were 316 trauma-related ankle and foot CT scans in the study period, from which it identified 72 (23%) adult patients with calcaneus fractures. Nineteen of these had bilateral calcaneal fractures. Therefore, the total number of fractures analysed further was 91, of which 72 (79%) were intra-articular and 19 (21%) were extra-articular. The Sanders classification was used in just over a third (n=25, 35%) of the radiology reports, with Sanders Type 4 fractures most observed (18/25, 72%). Most of the concomitant fractures were observed in the tarsal bones. CONCLUSIONS: Calcaneal fractures represent a prevalent injury within the spectrum of foot and ankle trauma. Sanders classification is a valuable tool for orthopaedic surgeons in pre-operative planning and prognosis prediction for calcaneal fractures; its incorporation into routine radiological reporting practices must be consistently observed.