Sanders classification of calcaneal fractures

vigente

Classifies intra-articular calcaneal fractures on coronal CT.

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Escala de categorias

I II III IV

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Procedência e vigência

Órgão emissor: Orthopedic consensus
Versão: 1993
Ano: 1993
Família: léxico
Tipo de lógica: flat
Modalidade: CT
Fonte primária: Operative treatment in 120 displaced intraarticular calcaneal fractures (Sanders)
Última verificação: 2026-06-26
Última checagem: 2026-06-26

Lógica de decisão

Forma estruturada (flat). Uma futura calculadora a lê; as categorias abaixo são a superfície legível.

Mostrar a lógica estruturada (JSON)

{
  "categories": [
    "I",
    "II",
    "III",
    "IV"
  ]
}

Categorias num relance

Cat.	Significado	Conduta	Risco	Fonte
I	Type I Non-displaced posterior facet fracture, regardless of the number of fracture lines seen on the coronal CT image.	Nondisplaced; managed conservatively (closed treatment, e.g., cast immobilization and protected weight-bearing); operative reduction is not required.	Best prognosis of the four types given the preserved articular alignment, though post-traumatic subtalar arthritis can still occur.	okfonte Criteria: Wikipedia 'Sanders classification', Classification section. Management/prognosis: NBK430861 (StatPearls, Calcaneus Fractures), Treatment ('Nondisplaced Sanders type I fractures may be treated in a conservative, closed fashion').
II	Type II Displaced fracture with one fracture line through the posterior facet (producing two articular fragments) on the coronal CT image at the widest point of the posterior facet.	Displaced intra-articular fracture; typically treated with open reduction and internal fixation (ORIF) to restore the posterior facet, though percutaneous techniques are used in selected cases.	Better long-term outcomes than type III; reported to require subsequent subtalar fusion far less often (type III was about 4x more likely to need eventual fusion than type II).	okfonte Criteria: Wikipedia 'Sanders classification', Classification section. Management/prognosis: NBK430861 (StatPearls, Calcaneus Fractures), Treatment/Prognosis ('Type III fractures were 4 times more likely to require eventual subtalar fusion compared to type II').
III	Type III Displaced fracture with two fracture lines through the posterior facet (producing three articular fragments, typically including a depressed central fragment) on the coronal CT image.	Displaced/comminuted intra-articular fracture; ORIF is the usual treatment, with patient counseling about the elevated likelihood of later subtalar fusion.	Worse prognosis than type II: about four times more likely to require eventual subtalar fusion; post-traumatic subtalar arthritis is common and recovery is prolonged.	okfonte Criteria: Wikipedia 'Sanders classification', Classification section. Management/prognosis: NBK430861 (StatPearls, Calcaneus Fractures), Prognosis ('Type III fractures were 4 times more likely to require eventual subtalar fusion compared to type II').; corroborated by PMC9572188 (type III vs IV outcomes).
IV	Type IV Comminuted fracture with more than three fracture lines in the posterior facet (four or more articular fragments) on the coronal CT image.	Highly comminuted; managed by ORIF or primary subtalar arthrodesis. Primary fusion is favored by some surgeons because it reduces the need for subsequent procedures.	Worst prognosis with the highest rate of subtalar arthritis and reoperation; higher wound-complication rates than type III, and outcomes converge toward poor with type III on long-term follow-up.	okfonte Criteria: Wikipedia 'Sanders classification', Classification section. Management/prognosis: NBK430861 (StatPearls, Calcaneus Fractures), Treatment ('Some surgeons will favor primary subtalar arthrodesis as it seems to reduce the need for subsequent procedures'); complication/outcome detail corroborated by PMC9572188.

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