2023, Vol. 27 ›› Issue (18): 2842-2847

Study on the distribution of calcaneal fracture line based on three-dimensional fracture map technology

Jiang Daixiang1, 2, Lu Hui1, 2, Ma Ling1, Zhang Hua1, Liu Dingxi3, Sheng Zhaoyou3, Wu Qimei4, Liu Rong1, 2, 5   

Abstract: BACKGROUND: Calcaneal fractures are extremely complex in terms of anatomy, biomechanics, and injury mechanisms, and are difficult to treat. The existing fracture classification systems are diverse, and the clinical selection is not uniform. In recent years, fracture mapping technology has become more and more perfect, and clinical research has gradually increased, providing new research ideas for fracture characteristics and injury mechanisms of fractures in various parts of the body.  
OBJECTIVE: To draw a calcaneal fracture line map and convert it into a heat map to analyze the characteristics of calcaneal fractures.
METHODS: The case data of 68 patients (74 feet) with calcaneal fractures were retrospectively studied. The CT scan data of the right calcaneus of a 34-year-old healthy male were selected for three-dimensional reconstruction and used as a template for drawing fracture lines. CT scan data of foot and ankle of 68 patients were imported into Mimics 20.0 software to reconstruct a three-dimensional fracture model. The fracture model was imported into 3-matic 12.0 software to simulate fracture reduction and to fit with the standard template. The fracture line was traced on the standard template. A fracture line map was created and converted into a heat map to analyze the fracture characteristics.  
RESULTS AND CONCLUSION: (1) Most of the patients with calcaneal fractures were 44-55 years old, of which 85.3% were male and 14.7% were female. (2) Three arc-shaped high-incidence areas were clearly visible on the map of calcaneal fractures. A belt: the annular high-incidence area of the lateral wall; B belt: covering the entire angle of Gissane and running towards the junction of the lateral tubercle and the bottom; C belt: from the middle of the posterior talar articular surface runs posteriorly and medially, and extends anteriorly by the tubercle in the medial wall. (3) The results show that the fracture map can directly display the characteristics of calcaneal fractures, and can provide references for further classification of calcaneus, internal fixation design, nail placement strategy, and finite element analysis validation.
Key words: calcaneal fracture, fracture map, fracture heat map, fracture line, three-dimensional reconstruction