# Sanders — Sanders classification of calcaneal fractures

> Classifies intra-articular calcaneal fractures on coronal CT.

**Situação:** vigente · **Órgão:** Musculoesquelético · **Órgão emissor:** Orthopedic consensus · **Versão:** 1993 · **Ano:** 1993

## Procedência e vigência
- Família: léxico
- Tipo de lógica: flat
- Modalidade: CT
- Fonte primária: Sanders R, Fortin P, DiPasquale T, Walling A. Operative treatment in 120 displaced intraarticular calcaneal fractures (Sanders) (1993) — https://en.wikipedia.org/wiki/Sanders_classification
- Última verificação: 2026-06-26
- Última checagem: 2026-06-26

## Categorias

| Código | Rótulo | Critérios | Conduta | Risco | Localizador | Verificado |
| --- | --- | --- | --- | --- | --- | --- |
| 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. | 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). | 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. | 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. | 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. | ✓ |

### Citações por categoria
- **I**: Sanders R, Fortin P, DiPasquale T, Walling A. Operative treatment in 120 displaced intraarticular calcaneal fractures (Sanders) (1993) — https://en.wikipedia.org/wiki/Sanders_classification · 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**: Sanders R, Fortin P, DiPasquale T, Walling A. Operative treatment in 120 displaced intraarticular calcaneal fractures (Sanders) (1993) — https://en.wikipedia.org/wiki/Sanders_classification · 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**: Sanders R, Fortin P, DiPasquale T, Walling A. Operative treatment in 120 displaced intraarticular calcaneal fractures (Sanders) (1993) — https://en.wikipedia.org/wiki/Sanders_classification · 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**: Sanders R, Fortin P, DiPasquale T, Walling A. Operative treatment in 120 displaced intraarticular calcaneal fractures (Sanders) (1993) — https://en.wikipedia.org/wiki/Sanders_classification · 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.


---
> Conteúdo de referência reescrito. Confira a publicação primária vigente. Não é dispositivo médico nem substitui o julgamento clínico. O radiologista responsável pelo laudo permanece o autor e o responsável.

Página HTML: https://radcommons.laudos.ai/systems/sanders · JSON da API: https://radcommons.laudos.ai/api/v1/systems/sanders · Índice para agentes: https://radcommons.laudos.ai/llms.txt