title: [3D navigated osteosynthesis of calcaneal fractures. Open and minimally invasive techniques].
abstract: BACKGROUND
  It is hypothesized that misplacement of sustentacular screws during osteosynthesis of intraarticular calcaneal fractures can be reduced with the help of navigation. A method for three-dimensional (3D) navigated placement of sustentacular screws for treating intraarticular calcaneal fractures is presented and evaluated.
  
  
  METHODS
  11 consecutive patients with 15 intraarticular calcaneal fractures were treated using 3D navigation. In 12 cases osteosynthesis was done through an extended lateral approach; in three cases, it was achieved through a minimally invasive percutaneous approach. For verification and documentation of the placed screws, a second 3D scan was performed.
  
  
  RESULTS
  A total of 20 screws were placed using 3D navigation. None of the navigated screws was misplaced. Extra operating time due to navigation averaged 11.9 minutes (+/-2.2 min).
  
  
  CONCLUSIONS
  Through a combination of intraoperative 3D imaging and navigation, placement of sustentacular screws is possible and can yield precise and reliable results. Especially in minimally invasive treatment, a high quality of osteosynthesis can be achieved.
authors.affiliation: Klinik und Poliklinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Münster, Münster. alex.ruebberdt@ukmuenster.de
authors.forename: A
authors.initials: A
authors.lastname: Rübberdt
authors.forename: V R
authors.initials: VR
authors.lastname: Hofbauer
authors.forename: M
authors.initials: M
authors.lastname: Herbort
authors.forename: L
authors.initials: L
authors.lastname: Löhrer
authors.forename: S
authors.initials: S
authors.lastname: Ochman
authors.forename: M J
authors.initials: MJ
authors.lastname: Raschke
mesh_terms: D000328:Adult; D000368:Aged; D002111:Calcaneus / Q000293:injuries* / Q000473:pathology / Q000601:surgery*; D004867:Equipment Design; D005260:Female; D018409:Foot Injuries / Q000473:pathology / Q000601:surgery*; D005593:Fracture Fixation, Internal / Q000295:instrumentation* / Q000379:methods; D050723:Fractures, Bone / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation* / Q000379:methods; D025321:Surgery, Computer-Assisted / Q000295:instrumentation* / Q000379:methods; D055815:Young Adult