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Calcaneal fractures: 3D-printing model to assist spatial weaving of percutaneous screws versus conventional open fixation—a retrospective cohort study

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Abstract

Purpose

This study compared the clinical effectiveness and wound complications of a three-dimensional model-assisted spatial weaving screw fixation (3D-SWSF) versus open reduction and internal fixation (ORIF) via an L-shaped extensile lateral approach for calcaneal fractures.

Methods

This single-centre retrospective cohort study was conducted with two cohort groups in which patients with Sanders II and III calcaneal fractures underwent 3D-SWSF or conventional ORIF. The clinical outcome measures included operation duration, time to operation, wound complications, blood loss volume, hospital stays, American Orthopedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot score, and visual analog scale (VAS) score. The pre-operative, post-operative, and one-year follow-up Gissane’s angle (GA), Böhler’s angle (BA), height, and width and length of the calcaneal fractures were also compared between the two groups.

Results

From Oct 2015 to Oct 2019, 31 patients received 3D-SWSF and 41 received conventional ORIF. A total of 11 (26.8%) patients in ORIF group had wound complications, compared with only two (6.5%) in 3D-SWSF group (p = 0.032). Operative time, blood loss, and hospital stay in 3D-SWSF group were lesser than those in ORIF group. The patients treated with 3D-SWSF had better AOFAS and VAS scores than those treated with ORIF at the last follow-up. The post-operative and one-year follow-up radiographic indexes as well as the GA, BA, length, width, and height of the calcaneal fractures were relatively comparable between the two groups.

Conclusion

Our study revealed that 3D-SWSF could effectively decrease the risk of wound complications, shorten operation time, reduce length of hospitalization, and improve post-operative rehabilitation.

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Data availability

The data used to support the findings of this study are available from the corresponding author upon request.

Abbreviations

3D:

Three-dimensional

3D-SWSF:

3D model-assisted spatial weaving screw fixation

AOFAS:

American Orthopedic Foot and Ankle Society

BA:

Böhler’s angle

DIACF:

Displaced intra-articular calcaneal fractures

ELA:

Extensile lateral approach

GA:

Gissane’s angle

HAS:

High axis screws

LAS:

Long axis screws

ORIF:

Open reduction and internal fixation

SS:

Sustentacular screws

VAS:

Visual analog scale

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Acknowledgements

The authors would like to express their gratitude to EditSprings (https://www.editsprings.com/) for the expert linguistic services provided.

Funding

This study was supported by the Medical and Health Technology Project of Zhejiang Province (No. 2019PY073, No. 2021PY072); Science and Technology research on public welfare project of Ningbo, Zhejiang Province (No. 2019C50050); and the Scientific Technology project of Agriculture and Social Development of Yinzhou, Ningbo, Zhejiang Province (No. 20180137, No. 20200132).

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Authors and Affiliations

  1. Department of Foot and Ankle Surgery, Shanghai Tongji Hospital, School of Medicine, Tongji University, Shanghai, 200065, China

    Yong Zhang & Yunfeng Yang

  2. Department of Trauma Orthopedics Surgery, Ningbo No.6 Hospital, Medical School of Ningbo University, Ningbo, 315040, Zhejiang, China

    Yong Zhang, Yang Gu & Jianming Chen

  3. Department of Neurology, The Affiliated Hospital of Medical School of Ningbo University, Ningbo, 315020, Zhejiang, China

    Qiuyan Weng

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Contributions

ZY provided the clinical data included in the manuscript. ZY and YY participated in the treatment decisions. ZY and GY wrote the manuscript draft. WQ, CJ, and GY revised it critically and approved the modified text. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Yunfeng Yang.

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Ethics approval and consent to participate

The study was approved by the Ethics Committee of the Ningbo No. 6 Hospital (No.2018–006). In this retrospective study, all participants gave their written informed consent to participate in the study.

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All participants gave their written informed consent to publish the obtained data of the current study.

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The authors declare no competing interests.

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Zhang, Y., Weng, Q., Gu, Y. et al. Calcaneal fractures: 3D-printing model to assist spatial weaving of percutaneous screws versus conventional open fixation—a retrospective cohort study. International Orthopaedics (SICOT) 45, 2337–2346 (2021). https://doi.org/10.1007/s00264-021-05094-2

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