Patient-specific instrument-assisted minimally invasive internal fixation of calcaneal fracture for rapid and accurate execution of a preoperative plan: A retrospective study

Background: Traditional methods for minimally invasive internal fixation (MIIF) of calcaneal fractures require extensive intraoperative fluoroscopy, and fracture recovery is usually not ideal. We developed a new surgical procedure using digital surgical simulation and constructed a patient-specific instrument (PSI) for calcaneal fracture that we used during the operation. This study investigated whether PSI-assisted MIIF of calcaneal fracture enables rapid and accurate execution of the preoperative plan.Methods: We retrospectively analyzed patients with Sanders type III or IV fresh calcaneal fractures who had undergone PSI-assisted MIIF at our hospital from January 2016 to December 2018. We analyzed perioperative data including intraoperative fluoroscopy time, concurrence of internal fixation actual usage (IFAU) with the preoperative plan, surgery time, and complications. We also compared pre- and postoperative actual measurements from X-ray radiographs and computed tomography images including Böhler, Gissane, and calcaneus valgus angles; subtalar joint width; and calcaneal volume overlap ratio with the preoperative design. All patients had been followed up and their American Orthopedic Foot and Ankle Score (AOFAS) score was available.Results: Mean intraoperative fluoroscopy time was 3.95±1.78 h; IFAU in 16 patients (16 feet) was the same as the preoperative plan; mean surgery time was 28.16±10.70 min; and none of the patients developed complications. Böhler, Gissane, and calcaneus valgus angles and subtalar joint width did not differ between pre- and postoperative plans; however, the actual preoperative values of each of these parameters differed significantly from those measured postoperatively. The calcaneal volume overlap ratio with the preoperative design was 91.2%±2.3%. AOFAS scores increased with time, with significant differences in the score at each time point.Conclusions: The newly developed PSI-assisted calcaneal fracture MIIF method can rapidly and accurately execute the preoperative plan.

Patient-specific instrument-assisted minimally invasive internal fixation of calcaneal fracture for rapid and accurate execution of a preoperative plan: A retrospective study

Background: Traditional methods for minimally invasive internal fixation (MIIF) of calcaneal fractures require extensive intraoperative fluoroscopy, and fracture recovery is usually not ideal. We developed a new surgical procedure using digital surgical simulation and constructed a patient-specific instrument (PSI) for calcaneal fracture that we used during the operation. This study investigated whether PSI-assisted MIIF of calcaneal fracture enables rapid and accurate execution of the preoperative plan. Methods: We retrospectively analyzed patients with Sanders type III or IV fresh calcaneal fractures who had undergone PSI-assisted MIIF at our hospital from January 2016 to December 2018. We analyzed perioperative data including intraoperative fluoroscopy time, concurrence of internal fixation actual usage (IFAU) with the preoperative plan, surgery time, and complications. We also compared pre- and postoperative actual measurements from X-ray radiographs and computed tomography images including Böhler, Gissane, and calcaneus valgus angles; subtalar joint width; and calcaneal volume overlap ratio with the preoperative design. All patients had been followed up and their American Orthopedic Foot and Ankle Score (AOFAS) score was available. Results: Mean intraoperative fluoroscopy time was 3.95±1.78 h; IFAU in 16 patients (16 feet) was the same as the preoperative plan; mean surgery time was 28.16±10.70 min; and none of the patients developed complications. Böhler, Gissane, and calcaneus valgus angles and subtalar joint width did not differ between pre- and postoperative plans; however, the actual preoperative values of each of these parameters differed significantly from those measured postoperatively. The calcaneal volume overlap ratio with the preoperative design was 91.2%±2.3%. AOFAS scores increased with time, with significant differences in the score at each time point. Conclusions: The newly developed PSI-assisted calcaneal fracture MIIF method can rapidly and accurately execute the preoperative plan.

Patient-specific instrument assisted calcaneal fracture minimally invasive internal fixation can carry out preoperative plan accurately and quickly: a retrospective study

Background: Almost all of the traditional calcaneal fracture minimally invasive internal fixations (MIIF) require a lot of intraoperative fluoroscopy, moreover, the fracture recovery of many patients is not considered ideal. Therefore, we designed a new surgical procedure through the digital surgical simulation and made patient-specific instrument (PSI) for calcaneal fracture patients before surgery, and then we manage the operation through the assistance of PSI during the whole process. The purpose of this study is to verify whether the PSI assisted calcaneal fracture minimally invasive internal fixation can carry out preoperative plan accurately and quickly. Methods: We retrospectively analyzed the Sanders type III or IV fresh calcaneal fracture patients who had been performed MIIF assisted by the PSI in our hospital during January 2016 to December 2018. We collected and analyzed perioperative data including intraoperative fluoroscopy times, whether the internal fixation actual usage (IFAU) same as preoperative plan, surgical time and situation of complication; and collected and analyzed the data of preoperative actual measurement, preoperative-plan and postoperative actual measurement from X-rays and CT, including Böhler angle, Gissane angle, subtalar joint width, calcaneus valgus angle and calcaneal volume overlapping ratio. All patients had been followed up and their AOFAS score had been recorded. Then we performed statistical analyses. Results: The intraoperative fluoroscopy times was 3.95±1.78, the condition of IFAU in 16 patients (16 feet) was the same as preoperative plan, the surgery time was 28.16±10.70 min, no patients developed complications. The preoperative plan Böhler angle, Gissane angle, subtalar joint width and calcaneus valgus angle were not significant different from the postoperative; the preoperative Böhler angle, Gissane angle, subtalar joint width and calcaneus valgus angle were all significant different from the postoperative. The calcaneal volume overlapping ratio with preoperative design was 91.2±2.3%. The AOFAS score of all patients gradually increased as time goes on, and difference of the AOFAS scores between all time-points were significant. Conclusions: The new patient-specific instrument assisted calcaneal fracture minimally invasive internal fixation can carry out the preoperative plan accurately and quickly.

Patient-specific instrument assisted calcaneal fracture minimally invasive internal fixation is accurate and practical: a retrospective study

Background: Almost all of the traditional calcaneal fracture minimally invasive internal fixation (MIIF) require a lot of intraoperative fluoroscopy, moreover, the fracture recovery of many patients are not considered ideal. Therefore, we designed a new surgical procedure through the digital surgical simulation and made patient-specific instrument (PSI) for calcaneal fracture patients before surgery, and then we manage the operation through the assistance of PSI during the whole process. The purpose of this study is to verify whether the PSI assisted calcaneal fracture minimally invasive internal fixation is accurate and practical. Methods: We retrospectively analyzed the Sanders type III or IV fresh calcaneal fracture patients who had been performed MIIF assisted by the PSI in our hospital during January 2016 to December 2018. We collected and analyzed perioperative data including intraoperative fluoroscopy times, whether the internal fixation actual usage (IFAU) same as preoperative plan, surgical time and situation of complication; and collected and analyzed the data of preoperative actual measurement, preoperative-plan and postoperative actual measurement from X-rays and CT, including Böhler angle, Gissane angle, subtalar joint width, calcaneus valgus angle and calcaneal volume overlapping ratio. All patients had been followed up and their AOFAS score had been recorded. Then we performed statistical analyses. Results: The intraoperative fluoroscopy times was 3.95±1.78, the condition of IFAU in 16 patients was the same as preoperative plan, the surgery time was 28.16±10.70 min, no patients developed complications. The preoperative plan Böhler angle, Gissane angle, subtalar joint width and calcaneus valgus angle were not significant different from the postoperative; the preoperative Böhler angle, Gissane angle, subtalar joint width and calcaneus valgus angle were all significant different from the postoperative. The calcaneal volume overlapping ratio with preoperative design was 91.2±2.3%. The AOFAS score of all patients gradually increased as time goes on, and difference of the AOFAS scores between all time-points were significant. Conclusions: The new PSI can indeed carry out the preoperative plan accurately and quickly, and the PSI assisted calcaneal fracture minimally invasive internal fixation is accurate and practical. Keywords: Digital surgical simulation; Patient-specific instrument; Calcaneal fracture; Minimally invasive internal fixation; Whole process-assisted surgical technique

Patient-specific instrument assisted calcaneal fracture minimally invasive internal fixation is accurate and practical: a retrospective study

Background: Almost all of the traditional calcaneal fracture minimally invasive internal fixation (MIIF) require a lot of intraoperative fluoroscopy, moreover, the fracture recovery of many patients are not considered ideal. Therefore, we designed a new surgical procedure through the digital surgical simulation and made patient-specific instrument (PSI) for calcaneal fracture patients before surgery, and then we manage the operation through the assistance of PSI during the whole process. The purpose of this study is to verify whether the PSI assisted calcaneal fracture minimally invasive internal fixation is accurate and practical. Methods: We retrospectively analyzed the Sanders type III or IV fresh calcaneal fracture patients who had been performed MIIF assisted by the PSI in our hospital during January 2016 to December 2018. We collected and analyzed perioperative data including intraoperative fluoroscopy times, whether the internal fixation actual usage (IFAU) same as preoperative plan, surgical time and situation of complication; and collected and analyzed the data of preoperative actual measurement, preoperative-plan and postoperative actual measurement from X-rays and CT, including Böhler angle, Gissane angle, subtalar joint width, calcaneus valgus angle and calcaneal volume overlapping ratio. All patients had been followed up and their AOFAS score had been recorded. Then we performed statistical analyses. Results: The intraoperative fluoroscopy times was 3.95±1.78, the condition of IFAU in 16 patients was the same as preoperative plan, the surgery time was 28.16±10.70 min, no patients developed complications. The preoperative plan Böhler angle, Gissane angle, subtalar joint width and calcaneus valgus angle were not significant different from the postoperative; the preoperative Böhler angle, Gissane angle, subtalar joint width and calcaneus valgus angle were all significant different from the postoperative. The calcaneal volume overlapping ratio with preoperative design was 91.2±2.3%. The AOFAS score of all patients gradually increased as time goes on, and difference of the AOFAS scores between all time-points were significant. Conclusions: The new PSI can indeed carry out the preoperative plan accurately and quickly, and the PSI assisted calcaneal fracture minimally invasive internal fixation is accurate and practical.