Automated Optical 3d Scanner to Assess Postoperative Edema Following Forefoot Surgery

Postoperative edema is a common and often underestimated consequence of forefoot surgery, potentially affecting wound healing, patient comfort, and recovery time. Traditional measurement techniques, such as water displacement and circumferential taping, have limitations in the immediate postoperative period due to infection risk and operator dependence. This study aimed to quantify and monitor with a 3D optical scanner the postoperative edema following forefoot surgery and to identify risk factors associated with increased edema volume.

In this prospective, single-center observational study, 108 patients undergoing forefoot surgery were evaluated using the UPOD-S 3D optical scanner. Each patient underwent serial volume assessments of both feet at baseline (Day 0, preoperatively), and postoperatively at Days 8, 21, 45, and 3 months. Patients were classified into three groups based on the type of surgery: isolated first ray procedures, combined first ray and lesser rays procedures, and isolated lesser ray procedures. A mixed-effects multivariate model was used to evaluate the impact of sex, age, BMI, surgical type, and postoperative footwear on volume changes.

The operated foot showed a significant increase in volume compared to baseline at all postoperative timepoints (p < 0.001), peaking at Day 21 (+78 cm³; +9%). Also, when compared to Day 8 postoperative, foot volume increased by 25 cm³ at Day 21 (p = 0.008) and decreased by 27 cm³ at 3 months (p = 0.003). Male sex (+169 cm³, p < 0.001) and elevated BMI (BMI 26-30: +59 cm³; BMI > 30; +109 cm³; p < 0.01) were independent predictors of increased edema. Surgery involving combined hallux and lesser rays led to greater volume increases (p > 0.001). Age and type of postoperative footwear had no significant impact.

We monitored forefoot surgery postoperative edema using 3D optical scanning. Male sex, elevated BMI, and multiple forefoot procedures were found to be key risk factors for prolonged or increased edema, which typically peaked at Day 21 and decreased thereafter in our study.