Imaging and clinical efficacy analysis of minimally invasive reduction and crossbar external fixation in the treatment of SandersⅡ and Ⅲ calcaneal fractures

Wang Jianchuan^1,2Xue qiwen²Guan tianmin^2*

• ¹Affiliated Zhongshan Hospital of Dalian University, Dalian, China
• ²School of Mechanical Engineering, Dalian Jiaotong University, Dalian, Liaoning Province, China

To evaluate the clinical efficacy of percutaneous minimally invasive reduction combined with crossbar external fixation in the treatment of Sanders type II and III calcaneal fractures. Methods: A retrospective analysis was performed on 65 patients with Sanders type II and III calcaneal fractures who were treated at Zhongshan Hospital affiliated with Dalian University between February 2019 and June 2021. Among them, 48 were males and 17 were females, with a mean age of 42.3±10.2 years. There were 45 cases of Sanders type II fractures and 20 cases of type III fractures. Patients were divided into three groups based on the surgical methods: Group A (n=25, minimally invasive reduction with crossbar external fixation), Group B (n=21, minimally invasive locking plate fixation via the sinus tarsi approach), and Group C (n=19, locking plate fixation via the lateral L-shaped incision). The following parameters were recorded and compared among the groups: preoperative waiting time, operative duration, intraoperative blood loss, incision length, and postoperative complications. Imaging parameters assessed included calcaneal length, width, height, Böhler angle, Gissane angle, and varus angle. Clinical outcomes were evaluated using the American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, Visual Analogue Scale (VAS), Short Form Health Survey (SF-36), and Maryland Foot and Ankle Score.Results: Baseline characteristics showed no significant differences among the groups (P>0.05). All patients were followed up for an average duration of 15.6±1.2 months. Furthermore, VAS scores 3 days postoperatively were significantly lower in group A compared to groups B and C (P<0.05), whereas no significant difference was observed between groups B and C.The incidence of postoperative complications was significantly lower in groups A and B compared with group C (P<0.05), with no significant difference observed between groups A and B. All imaging parameters significantly improved postoperatively within each group (P<0.05). At the final follow-up, clinical outcomes (AOFAS, SF-36, Maryland scores) showed no significant differences among groups (P>0.05).The Percutaneous minimally invasive reduction combined with crossbar external fixation provides effective fixation with minimal trauma, shorter hospital stays, and lower complication rates, r epresenting a viable treatment strategy for Sanders type II and III calcaneal fractures.