A Novel Combination of Printed 3-Dimensional Anatomic Templates and Computer-assisted Surgical Simulation for Virtual Preoperative Planning in Charcot Foot Reconstruction

doi:10.1053/j.jfas.2012.01.014

The Journal of Foot and Ankle Surgery

Volume 51, Issue 3, May–June 2012, Pages 387-393

https://doi.org/10.1053/j.jfas.2012.01.014 Get rights and content

Abstract

Charcot foot syndrome (Charcot neuroarthropathy affecting the foot), particularly in its latter stages, may pose a significant technical challenge to the surgeon. Because of the lack of anatomic consistency, preoperative planning with virtual and physical models of the foot could improve the chances of achieving a predictable intraoperative result. In this report, we describe the use of a novel, inexpensive, 3-dimensional template printing technique that can provide, with just a normal printer, multiple “copies” of the foot to be repaired. Although we depict this method as it pertains to repair of the Charcot foot, it could also be used to plan and practice, or revise, 3-dimensional surgical manipulations of other complex foot deformities.

Section snippets

Data Acquisition and Processing

Before surgery, clinical and standard radiographic evaluations revealed midfoot collapse and deformity (Fig. 1, Fig. 2). Computed tomographic (CT) scans, averaging 1-mm-thick slices, of the patient's involved foot were also obtained (Fig. 3). The digital information (Digital Imaging and Communications in Medicine [DICOM^SM]) service–marked technology managed by Medical Imaging and Technology Alliance (MITA), a division of National Electrical Manufacturers Association (NEMA^®, Rosslyn, VA),

Discussion

Charcot foot reconstruction remains a challenging surgical adventure, with many operative and postoperative uncertainties. Although improvements in surgical technology, sophisticated fixation hardware, and surgical experience are all thought to contribute to improved surgical outcomes, Charcot neuroarthropathy is still considered by many foot and ankle surgeons to be wrought with morbidity (poor bone stock, obesity, edema, insensitivity) and complications (fracture, osteomyelitis, fixation

Acknowledgments

We give special thanks to Kristian Spivey and the DeKalb Medical Department of Radiology for taking time out of their busy schedule to accommodate and assist us.

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: Conflict of Interest: None reported.

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Tips, Quips, and PearlsA Novel Combination of Printed 3-Dimensional Anatomic Templates and Computer-assisted Surgical Simulation for Virtual Preoperative Planning in Charcot Foot Reconstruction

Abstract

Section snippets

Data Acquisition and Processing

Discussion

Acknowledgments

Clin Podiatr Med Surg

J Foot Ankle Surg

J Foot Ankle Surg

J Foot Ankle Surg

Clin Podiatr Med Surg

Oral Surg Oral Med Oral Pathol Oral Radiol Endod

HPB (Oxford)

Tips, Quips, and Pearls
A Novel Combination of Printed 3-Dimensional Anatomic Templates and Computer-assisted Surgical Simulation for Virtual Preoperative Planning in Charcot Foot Reconstruction