Effect of Intraoperative Three-Dimensional Imaging During the Reduction and Fixation of Displaced Calcaneal Fractures on Articular Congruence and Implant Fixation

Foot & Ankle International
Henrik Eckardt, Marianne Lind

Abstract

Operative treatment of displaced calcaneal fractures should restore joint congruence, but conventional fluoroscopy is unable to fully visualize the subtalar joint. We questioned whether intraoperative 3-dimensional (3D) imaging would aid in the reduction of calcaneal fractures, resulting in improved articular congruence and implant positioning. Sixty-two displaced calcaneal fractures were operated on using standard fluoroscopic views. When the surgeon had achieved a satisfactory reduction, an intraoperative 3D scan was conducted, malreductions or implant imperfections were revised, the calcaneus was rescanned, and this sequence was repeated until the optimal operative result was achieved. Five fractures underwent 1 intraoperative scan, 39 fractures underwent 2 scans, 13 fractures underwent 3 scans, and 5 fractures underwent 4 scans. The average number of scans was 2.3. Intraoperative scanning led to re-reduction and improvement of reduction in 13 fractures, change of plate position in 1 patient, optimizing of the screw directions in 5 fractures, and shortening of screws that were intra-articular or protruding medially in 6 fractures. The postoperative articular displacement was 0 mm in 69% of the Sanders type 2 fractures and 57...Continue Reading

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Citations

Feb 6, 2018·Journal of Orthopaedic Trauma·Phillip M MitchellCory A Collinge
Sep 25, 2017·Archives of Orthopaedic and Trauma Surgery·M S H BeerekampJ C Goslings
Jul 12, 2018·Current Reviews in Musculoskeletal Medicine·Emily A Wagstrom, Jessica M Downes
Oct 28, 2020·Archives of Orthopaedic and Trauma Surgery·Sebastian FischerSebastian Manegold

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