Three-dimensional printing technique aids screw insertion into the sustentaculum tali of the internal fixation of intra-articular calcaneal fractures

Introduction

Treating complex calcaneus fractures remains challenging. This study evaluated the influence of 3D printing and simulation on precision screw insertion into the calcaneus sustentaculum tali (ST).

Hypothesis

3D printing and simulation improve the treatment for calcaneal fracture.

Patients and methods

This retrospective cohort study included 85 patients admitted with 93 Sanders type II–IV intra-articular fractures from January 2015 to June 2020. Multi-slice computed tomography (MSCT) images were used in the conventional group, and MSCT data were used to construct a 3D model of the calcaneus to simulate screw insertion and verify parameter accuracy in the 3D group.

Results

The designed parameters (upward and backward oblique angles and screw-path length) were similar to the actual values in the 3D group (p = 0.428,0.287,0.585) but not in the conventional group (p = 0.01,0.002,0.023). The Maryland foot functional score, accuracy rate, and average screw number were higher and operative time was shorter in the 3D group (p = 0.005,0.007,0.000,0.000).

Discussion

Preoperative simulation using the 3D printing model helped guide the screws into the ST more accurately, lending better-quality treatment for Sanders type II–IV calcaneal fractures.

Level of proof

III; Retrospective case-control study.