Enhancing orthopaedic resident competency in calcaneal fracture evaluation with Sanders classification: A comparative study of computed tomography, 3D printing and virtual reality
Foot and Ankle Surgery, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Basım Tarihi: 2026
- Doi Numarası: 10.1016/j.fas.2026.07.013
- Dergi Adı: Foot and Ankle Surgery
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, MEDLINE, Academic Search Ultimate (EBSCO)
- Anahtar Kelimeler: Calcaneal fractures, Computed tomography, Fracture classification, Three-dimensional printing, Virtual reality
- İstanbul Üniversitesi-Cerrahpaşa Adresli: Evet
Özet
Background Interpretation of intra-articular calcaneal fractures using the Sanders classification remains challenging because of complex three-dimensional morphology. This study compared CT, 3D printing, and virtual reality (VR) for Sanders classification. Methods Thirty-three calcaneal fractures were assessed by 25 orthopaedic residents using CT, 3D-printed models, and VR. Interobserver agreement and within-observer cross-modality concordance were analysed using Cohen’s kappa (κ) and intraclass correlation coefficients (ICC). Accuracy was compared with a composite reference standard. Results Interobserver agreement was highest with 3D printing (κ = 0.26; ICC = 0.90). CT showed the highest overall classification accuracy (p < 0.001). Agreement and accuracy were not affected by training level or session. VR was the preferred modality (80%). Conclusions 3D visualization improved interobserver agreement, whereas CT remained the most accurate modality. VR showed strong perceived educational value. Modality-dependent differences suggest that 3D methods may complement and refine CT-based Sanders classification. Level Level II diagnostic evidence.