Three-Dimensional (3D) Computed Tomographic (CT) Assessment of the Sustentaculum Tail to Find Distinctive Characteristics: Implications for Surgery

Abstract

BackgroundWith the complexity of calcaneal fracture (CF) increasing, its treatment has changed to include inserting the screw used to secure the facies articular posterior into the sustentaculum tail (ST). Some research progress has been made in this area, but there has been little in-depth research on the anatomical morphology of the sustentaculum tail, which is necessary for clinical surgery, and more information about Chinese anatomic characteristics and improved surgical techniques for CF are needed.Material/MethodsThis anatomical study, based on a three-dimensional (3D) computed tomographic (CT) reconstruction technique, included 287 dry calcaneus, consisting of 144 left and 143 right calcaneus. The images were reconstructed in 3D after CT scanning. Seven subjects were enrolled (L and R): (1) The vertical distance from inside the sustentaculum tail (IST) to inside the facies articularis talaris posterior; (2) The vertical distance from IST to the outside facies articularis talaris posterior; (3) The thickness of sulcus calcaneal nadir; (4) The distance from IST to processus medislis tuberis calcaneus; (5) The distance from IST to calcaneal posterosuperior tuber; (6) The angle of the prolate axial intersection between ST and calcaneus on the normal superior as ∠α; and (7) The angle of the prolate axial intersection between ST and calcaneus on the normal posterior as ∠β. All measurement results were analyzed by SPSS 22.0.ResultsBased on morphological classification, the average length of AB, AC, AE, and AF on left ST were 16.956±1.391 mm, 37.803±2.525 mm, 43.244±3.617 mm, and 51.113±4.455 mm, respectively. Among the others, ∠β was 81.227±6.317 mm on the left and 74.581±9.008 mm on the right (P<0.05).ConclusionsThese results suggest better ways to treat the special characteristics and to reduce the risk of CF surgery.

Elaboration of a multimodal MRI-based radiomics signature for the preoperative prediction of the histological subtype in patients with non-small-cell lung cancer

“…Besides, the proposed approach in our study could also realize the quantitative estimation and risk stratification for patients with LUSC and LUAD, promisingly working as an effective and complementary tool to help the clinicians make appropriate treatment decisions. Apart from the current study, development of the quantitative image-based diagnostic models for disease definition has received unprecedented attention these years [2,7,18,25,38,[43][44][45][46][47], not only in the field of cancer diseases, but also in more broad research fields, such as retinal diseases [43,44], diabetes [46], calcaneal fracture [45], and mental disorders [36]. These models have achieved favorable performance in diseases diagnoses and understanding, demonstrating the great power and promising application of these approaches for clinical practice.…”

Anatomical parameters of sustentaculum Tali screw placement in the Asian population: A retrospective radio-anatomical study

“…At present, no consensus on the definition of optimal reference lines has been reached. Here are some reference markers that were commonly used in former studies: the longitudinal axis of the calcaneus, 6 the floor, 6 PTAS, 16 the highest point of calcaneal tuberosity, 21 etc. In fact, the axis of the whole foot is more important to surgeons than the calcaneal axis because the axis of the entire foot is more practical in surgical positions.…”

“…The optimal entry point has been looked at by multiple other studies with no real consensus. For example, some researchers proposed that the entry point should locate below the middle part of the lateral edge of PTAS, and too anterior or too posterior were not appropriate 21,22 while other researchers believed the optimal entry point should have a PEDL of 15 mm and the anterior, middle and posterior parts of the lateral wall of PTAS were all suitable for screw placement. 16 Although the definition of entry point varies, there are always two essential parameters: the PDEL and the part of the entry point that locates at the lateral wall of PTAS (anterior, middle, or posterior one-third section).…”