Can 3-Dimensional Printing for Calcaneal Fracture Surgery Decrease Operation Time and Improve Quality of Fracture Reduction?

We investigated whether 3-dimensional (3D) printed models can decrease operation time and improve the quality of reduction for calcaneal fractures. The study involved 48 patients with unilateral intra-articular calcaneal frac-tures, who were retrospectively case-matched according to Sander's classification, age, and sex. Group A (24 patients) was operated using 3D printed models as a preoperative and intraoperative tool, and group B (24 patients) was operated using standard techniques without 3D printed model. Operation time was significantly shorter for group A, compared to group B (82.3 +/- 13.2 vs 91.4 +/- 16.0, p = .036). The differences between the radio-logical parameters of operated calcaneus, compared to the normal side was similar between the 2 groups (Bo euro hler angle, 5.3 degrees +/- 3.9 degrees vs 4.2 degrees +/- 4.7 degrees, p = .45, Gissane angle, 5.9 degrees +/- 12.5 degrees vs 8.4 degrees +/- 11.0 degrees, p = .54). The number of screws projecting more than 5 mm from the cortex was lower in group A than in group B (7/187, 4% vs 16/208, 8%, p = .11). The number of screw holes of the plate cut intraoperatively was significantly lower for group A compared to group B (1 vs 138). Although group A started weightbearing 3 to 4 weeks earlier than group B, the radiological parameters were similar between groups that early weightbearing was possible for group A using the 3D printed models (Bo euro hler angle, -1.5 degrees +/- 0.8 degrees vs -1.8 degrees +/- 1.2 degrees, p = .28, Gissane angle, 2.5 degrees +/- 2.6 degrees vs 3.5 degrees +/- 4.3 degrees, p = .39). The operation time was shorter while using the 3D printed models, compared to that of the standard technique with-out using the 3D printed model. The radiological parameters were not statistically different, and the quality of fracture reduction seemed similar. However, with the use of 3D printed models, early weightbearing was possible without significant subsidence of reduced fragments or failure of fracture reduction, comparable to non-weight-bearing cases.(c) 2022 by the American College of Foot and Ankle Surgeons. All rights reserved.