Marker-3D Measurement Versus Traditional Radiograph Measurement in the Treatment of Tibiofibular Fracture Using Taylor Spatial Frame

Abstract

Background: The Taylor Spatial Frame (TSF) has been widely used for tibiofibular fractures. However, traditional radiograph measurement method is complicated and the reduction accuracy is not high enough for correcting residual deformities. We proposed the marker-3D measurement method to solve these problems. This study aimed to compare the reduction accuracy of the traditional radiograph measurement method and the marker-3D measurement method in tibiofibular fracture treated with TSF.Methods: From January 2016 to June 2019, A retrospective analysis was performed based on the patients with tibiofibular fracture treated with TSF in our department. 41 patients were qualified for this study, including 21 patients in the marker-3D measurement group (experimental group) and 20 patients in the traditional radiograph measurement group (control group). In the experimental group, CT scan was performed for 3D reconstruction with 6 markers installed on the TSF, to determine the adjusting plan. In the control group, the anteroposterior (AP) and lateral radiographs were performed for the deformity parameters. X-rays were taken to measure the residual deformities after correction.Results: All patients reached functional reduction. The residual displacement deformity (RDD) in AP radiograph was 0.5 (0, 1.72) mm in experimental group and 1.74 (0.43, 3.67) mm in control group. The residual angle deformity (RAD) in AP radiograph was 0 (0, 1.25) ° in experimental group and 1.25 (0.62, 1.95) °in control group. As to the Lateral radiograph, the RDD was 0 (0, 1.22) mm in experimental group and 2.02 (0, 3.74) mm in control group. The RAD was 0 (0, 0) ° in experimental group and 1.42 (0, 1.93) ° in control group. Significant differences in all above comparisons were found between the groups (AP radiograph RDD: P = 0.024, RAD: P = 0.020; Lateral radiograph RDD: P = 0.016, RAD: P = 0.004). Conclusions: Both groups achieved satisfactory fracture reduction. However, the residual deformities in the experimental group were significantly smaller. This study proved that the marker-3D measurement method could further improve the reduction accuracy.