A 35-year-old falls from a height and sustains bilateral calcaneal fractures. CT scan shows a fracture with involvement of the posterior facet of the subtalar joint. The CT classification most widely used for surgical planning of calcaneal fractures is:
- A Sanders classification based on CT coronal cuts ✓
- B Essex-Lopresti classification (tongue vs. joint depression type)
- C Böhler's angle measurement
- D AO/OTA alphanumeric classification
Explanation
The Sanders classification uses CT coronal cuts at the widest part of the posterior facet to classify the number and position of fracture lines: Type I (undisplaced), Type II (one fracture line — 2 fragments), Type III (two lines — 3 fragments), Type IV (comminuted — 4+ fragments). It directly guides surgical decision-making: Sanders I/II → ORIF or conservative; Sanders III → ORIF; Sanders IV → primary subtalar arthrodesis considered. Essex-Lopresti is a plain radiograph classification and less precise for surgical planning. Böhler's angle assesses depression severity but not fracture pattern.
Reference: Maheshwari Essential Orthopaedics, 6th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.