ORIGINAL RESEARCH article
Front. Surg.
Sec. Orthopedic Surgery
Volume 12 - 2025 | doi: 10.3389/fsurg.2025.1599356
This article is part of the Research TopicSurgical Advances in Orthopedic Trauma: A Biomechanical ApproachView all 9 articles
A tailored distractor-assisted percutaneous minimally invasive treatment for Sanders Ⅱ and Ⅲ calcaneus fractures: a comparative cohort study with medium-term results Brief title: A tailored distractor for calcaneus fractures treatment
Provisionally accepted
- 1Changsha Central Hospital, Changsha, China
- 2Hengyang Medical College, University of South China, Hengyang, Hunan Province, China
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A tailored distractor-assisted percutaneous minimally invasive treatment for Sanders Ⅱ and Ⅲ calcaneus fractures: a retrospective cohort study with 2-year follow-up Abstract Background The treatment strategy of displaced intra-articular calcaneal fractures (DIACFs) remains challenging. While the operation techniques vary widely, the efforts is now on the optimization of surgical techniques to better DIACFs management. This study aimed to introduce a tailored distractor-assisted percutaneous minimally invasive surgery(MIS) and reported its medium-term outcomes in patients with Sanders Ⅱ and Ⅲ calcaneus fractures. Methods 63 cases (63 feet) of DIACFs, subjected to a tailored distractor-assisted MIS in our orthopedic department were retrospectively analyzed. The medical records and radiological measurements were retrieved for efficiency evaluation. At the last follow-up, the American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hind foot score and Visual Analog Scale (VAS) score were used to evaluate the functional rehabilitation. Postoperative complications were also recorded. Results All feet (39 Sanders type Ⅱ fractures and 24 Sanders type Ⅲ) successfully achieved fracture reduction with the interval between injury to operation average 1.3 days, the duration of surgery average 40.1 minutes, and the hospital stay average 4.9 days. Radiographic measurements revealed significant differences between pre-operation and post-operation in calcaneal height and width, so as to Bohler’s angle and Gissane angle (p<0.05, respectively). Anatomical or near-anatomical realignment of the posterior subtalar articular surfaces were achieved in all cases. At the last follow-up, the AOFAS and the VAS score was average 81.4 and 1.3 points, both significantly improved from that of pre-operation (p<0.05, respectively). Four feet (6.3%) encountered postoperative complications. Conclusion Application of the tailored calcaneal distractor in MIS for Sanders type II and III calcaneal fractures has demonstrated advantages in effectively manipulating fracture reduction and yielding favorable clinical outcomes. Further cohort study is required to clarify its clinical significance vs other techniques.
Keywords: Calcaneus fracture, Calcaneal distractor, Foot surgery, Fracture reduction, minimally invasive surgery
Received: 24 Mar 2025; Accepted: 16 Jul 2025.
Copyright: © 2025 Liao, Deng, Liu and You. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Xiong Liao, Changsha Central Hospital, Changsha, China
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