Definition of sustentacular screw length based on computed tomography measurements for calcaneus intraarticular fracture surgery

Year 2020, , 203 - 207, 19.01.2021

Can Doruk Basa , Emre Sarıekiz İsmail Kaçmaz Ali Er Vadym Zhamilov , Ali Reisoğlu Oğuzhan Ekizoğlu

https://doi.org/10.5505/deutfd.2020.96158

Abstract

Objective: It was aimed to define radiologically the length of the sustentacular screw for guidance of calcaneus intraarticular fracture surgery.
Materials and Methods: In this radiological measurement study, computed tomography (CT) images of 200 (100 males, 100 females) patients who underwent multidetector lower extremity CT were investigated. CT axial sections were subjected to coronal and sagittal multiplanar reconstruction. The longest calcaneal diameters in the axial, sagittal, and coronal planes were measured. The distance between the standardized entry point of the screw on the lateral wall of calcaneus and the sustentaculum tali was measured.
Results: Mean age was 42.31 ± 13.64 years (minimum, 18 years; maximum, 82 years). The distance from the determined point on the lateral wall to the sustentaculum tali (LSA) was measured along the axial plane and was 46.08 ± 4.34 mm in males and 41.37 ± 2.97 mm in females. The distance between the lateral wall and the sustentaculum tali (LSC) in the coronal plane was 50.15 ± 3.89 mm in males and 43.65 ± 3.50 mm in females.
Conclusion: If mean community values are available, evaluation of screw length and calcaneal morphometry using preoperative images will enhance surgical success.

Keywords

calcaneus, sustentacular screw, morphometry, population, trauma

Kalkaneus intraartiküler kırık cerrahi tedavisinde bilgisayarlı tomografi üzerinden sustentakuler vida uzunluğunun belirlenmesi

Abstract

Amaç: Çalışmada kalkaneus intraartiküler kırıkları cerrahisinde kullanılan sustentakuler vidanın boyunun radyolojik olarak belirlenmesi amaçlanmıştır.
Gereç ve Yöntem: Bu radyolojik ölçüm çalışmasına, alt ekstremite bilgisayarlı tomografisi (BT) çekilmiş olan 200 hasta (100 erkek, 100 kadın) dâhil edildi. Aksiyel BT kesitleri görüntüleri, koronal ve saggital multiplanar rekonstrükte edildi. Kalkanusun aksiyel, koronal ve saggital plandaki en uzun mesafesi ölçüldü. Ayrıca sustentakulum talinin en çıkıntılı noktası ile standardize edilmiş kalkaneus lateral duvarındaki nokta arasındaki mesafe koronal ve aksiyel planda ölçüldü.
Bulgular: Ölçüm yapılan BT’lerin ait olduğu kişilerin ortalama yaşı 42,31±13,64 (minimum, 18; maksimum, 82) idi. Aksiyel planda kalkaneustaki vidanın giriş yerine ait olan lateral duvar noktası ile sustentakulum tali arasındaki mesafe (LSA) erkeklerde 46,08±4,34 mm ve kadınlarda 41,37±2,97 mm idi. Koronal planda kalkaneustaki vidanın giriş yerine ait olan lateral duvar noktası ile sustentakulum tali arasındaki mesafe (LSC) erkeklerde 50,15±3,89 mm ve kadınlarda 43,65±3,50 mm idi.
Sonuç: Topluma ait ortalama ölçümlerin bilinmesi durumunda, ameliyat öncesi yapılacak ölçümlerle birlikte hesaplanacak sustentakuler vida uzunluğu ve morfometrik ölçümler cerrahinin başarısını arttıracaktır.

Keywords

kalkaneus, sustentakuler vida, morfometri, popülasyon, travma

References

• Epstein N, Chandran S, Chou L. Current concepts review: intra-articular fractures of the calcaneus. Foot Ankle Int. 2012;33:79-86.
• Wei N, Zhou Y, Chang W, Zhang Y, Chen W. Displaced Intra-articular Calcaneal Fractures: Classification and Treatment. Orthopedics. 2017;40:e921-9.
• Buckley R, Tough S, McCormack R, et al. Operative compared with nonoperative treatment of displaced intra-articular calcaneal fractures: a prospective, randomized, controlled multicenter trial. J Bone Joint Surg Am. 2002;84:1733-44.
• Lim EV, Leung JP. Complications of intraarticular calcaneal fractures. Clin Orthop Relat Res. 2001:7-16.
• Schepers T, van Lieshout EM, van Ginhoven TM, Heetveld MJ, Patka P. Current concepts in the treatment of intra-articular calcaneal fractures: results of a nationwide survey. Int Orthop. 2008;32:711-15.
• Fan B, Zhou X, Wei Z, Ren Y, Lin W, Hao Y, et al. Cannulated screw fixation and plate fixation for displaced intra-articular calcaneus fracture: A meta-analysis of randomized controlled trials. Int J Surg. 2016;34:64-72.
• Tantavisut S, Phisitkul P, Westerlind BO, Gao Y, Karam MD, Marsh JL. Percutaneous Reduction and Screw Fixation of Displaced Intra-articular Fractures of the Calcaneus. Foot Ankle Int. 2017;38:367-74.
• Gitajn IL, Abousayed M, Toussaint RJ, Ting B, Jin J, Kwon JY. Anatomic Alignment and Integrity of the Sustentaculum Tali in Intra-Articular Calcaneal Fractures: Is the Sustentaculum Tali Truly Constant? J Bone Joint Surg Am. 2014;96:1000-5.
• Bussewitz BW, Hyer CF. Screw placement relative to the calcaneal fracture constant fragment: an anatomic study. J Foot Ankle Surg. 2015;54:392-4.
• Yu X, Pang QJ, Chen L, Yang CC, Chen XJ. Postoperative complications after closed calcaneus fracture treated by open reduction and internal fixation: a review. J Int Med Res. 2014;42:17-25.
• Albert MJ, Waggoner SM, Smith JW. Internal fixation of calcaneus fractures: an anatomical study of structures at risk. J Orthop Trauma. 1995;9:107-12.
• Bidmos MA, Asala SA. Discriminant function sexing of the calcaneus of the South African whites. J Forensic Sci. 2003;48:1213-8.
• Gualdi-Russo E. Sex determination from the talus and calcaneus measurements. Forensic Sci Int. 2007;171:151-6.
• Kim DI, Kim YS, Lee UY, Han SH. Sex determination from calcaneus in Korean using discriminant analysis. Forensic Sci Int. 2013;228:177.e1-7.
• Ekizoglu O, Inci E, Palabiyik FB, Can İO, Er A, Bozdag M, et al. Sex estimation in a contemporary Turkish population based on CT scans of the calcaneus. Forensic Sci Int. 2017;279: 310.e1-310.e6.
• Olexa TA, Ebraheim NA, Haman SP. The sustentaculum tali: anatomic, radiographic, and surgical considerations. Foot Ankle Int. 2000;2:400-3.
• Tomesen T, Biert J, Frolke JP. Treatment of displaced intra-articular calcaneal fractures with closed reduction and percutaneous screw fixation. J Bone Joint Surg Am. 2011;93:920-8.
• Gras F, Marintschev I, Wilharm A, Lindler R, Klos K, Mückley T, et al. [Sustentaculum tali screw placement for calcaneus fractures--different navigation procedures compared to the conventional technique]. Z Orthop Unfall. 2010;148:309-18.
• Wang Z, Wang XH, Li SL, Tang X, Fu BG, Wang MH, et al. Minimally invasive (sinus tarsi) approach for calcaneal fractures. J Orthop Surg Res. 2016;11:164.
• Wang C, Huang D, Ma X, Wang X, Huang J, Zhang C, et al. Sustentacular screw placement with guidance during ORIF of calcaneal fracture: an anatomical specimen study. J Orthop Surg Res. 2017;12:78.