Evaluation of Sanders Type 2 Joint Depression Calcaneal Fractures in 197 Patients from a Single Center Using Three-Dimensional Mapping

Abstract

Background This study aimed to evaluate Sanders type 2 calcaneal fractures in 197 patients from a single center using the 3D (three-dimensional) CT (computed tomography) mapping method. Material/Methods A consecutive series of 197 Sanders type 2 joint depression calcaneal fractures was used. The segment and split functions were used to create each calcaneal fragment using Mimics Research 20.0 software. The fracture fragments were reduced in 3-matic Research 12.0 software. In the E-3D Medical 18.01 software, after superimposing the fractured calcaneus entity with the calcaneus template, we drew the fracture line on the template. Finally, the heatmap was obtained by fracture statistical analysis function. Simultaneously, the distribution of the fracture lines in the anterior part of the calcaneus (APC) and middle talar joint was recorded. Results There were 109 cases of Sanders type 2A, 46 cases of Sanders type 2B, and 42 cases of Sanders type 2C. Based on the data, we drew the characteristic fracture map of type 2A 2B and 2C. This study found that the most common types of Sanders type 2A in APC and middle talar articular surface are type AC and type AD. In Sanders type 2B, the most common type is type AC, and in Sanders type 2C it is type ACD. Conclusions The findings from this study showed that 3D CT imaging and reconstruction of the calcaneus was a useful diagnostic method to evaluate and classify joint depression calcaneal fractures. The calcaneal fracture map can be used to guide surgical planning and optimize the design of internal fixation.

Design and finite element analysis of cross-screw fixation strategy for Sanders IIB calcaneal fractures

“…Notably, several scholars have conducted comprehensive fracture heatmap studies on the calcaneus. Guo et al [10] developed a Sanders Type II calcaneal fracture heatmap by utilizing CT data from 193 patients. This heatmap visually illustrates the fracture patterns of subtypes a, b, and c. Within the Sanders Type II B calcaneal fracture heatmap, several high-incidence fracture lines divide the calcaneus into four primary fracture blocks: the calcaneal tuberosity fragment(CTF), the sustentaculum tali fragment(STF), the anterior process fragment(APF), and the lateral articular fragment(LAF).…”

“…Over the past three decades, numerous scholars have undertaken comprehensive studies on the anatomical application of internal fixation techniques for calcaneal fractures [6][7][8]. Furthermore, recent advancements in the field, such as the development and implementation of fracture heatmaps, have led to increasingly refined research on fracture morphology in calcaneal fractures [9,10].…”

Three‐dimensional Mapping Analysis of Talus Fractures and Demonstration of Different Surgical Approaches for Talus Fractures

“…Surgeons can use this 3D model to better plan the surgical procedure by visualizing the location, size, and orientation of the fracture in 3D, which aids in the identification of the best surgical approach, determination of the type and size of implants required, and optimization of implant placement. Previous studies have described the application of mapping and thermographic methods to investigate fracture line patterns of the ankle, calcaneal, and fifth metatarsal fractures; 9 , 10 , 11 however, these methods have not been applied to the talus.…”

Morphology and novel classification of proximal humeral fractures

“…Fracture mapping, initially proposed by Armitage et al (2009) , is a method to visually display the fracture morphology by superimposing fracture lines of multiple fracture models onto a normal model through 3D CT reconstruction ( Guo et al, 2021a ; Guo et al, 2021b ). The fracture map provides a visual representation of the position, direction, and distribution of the fracture line ( Ding et al, 2022 ).…”