Volumetric assessment of the soft tissue envelope in unilateral closed ankle fractures using a portable 3D scanner.

Abstract

Management of ankle fractures necessitating surgery is impacted by soft tissue swelling, often delaying open reduction and internal fixation (ORIF). Subjective evaluations are inconsistent, and traditional measurement methods are often inaccurate or impractical. This prospective observational study included 17 adults with unilateral closed ankle fractures requiring surgical fixation. A measurement protocol on regions of interest (ROI) was utilized, employing a handheld 3D scanner for daily volume scans of the fractured ankle, comparing these measurements with subjective assessments of swelling using a numerical scale. The 3D scanner detected significant soft tissue volume reductions of the ROI over 14 days, with reductions of 25 ± 25 % in the lower limb and 16 ± 9 % in the ankle. Significant swelling reduction was noted from day 8, preceding surgeons' assessments (days 11-14). The scanner exhibited high reproducibility, providing an objective tool for comparative studies on decongestive measures in perioperative soft tissue management. LEVEL OF EVIDENCE: 2 - Diagnostic Level 1 - Prognostic Level 1 - Prospective comparative study Level 2.