Purpose Several minimally invasive procedures were used to treat displaced intra-articular calcaneal fractures (DIACFs). No agreement among different authors about either the ideal fixation method or which technique is minimally invasive. The aim of this study was to compare functional and radiographic outcomes of two minimally invasive techniques in treatment of Sanders type II and III DIACFs by using K-wires or cannulated screws without bone grafts. Methods A prospective randomized controlled study was conducted on 28 patients (34 feet) with Sanders type II or III DIACFs, treated by closed reduction and fixation using cannulated screws or K-wires, at the Orthopedics Department of Sohag University Hospital, between April 2020 and February 2022. Functional assessment was done by American Orthopedic Foot and Ankle Society (AOFAS) score and VAS for pain. Radiographic assessment was done by measurement of three calcaneal angles (Gissane, Böhler’s, and posterior facet inclination angles) and three calcaneal distances (height, length, and width of the calcaneus). Results Mean ages of patients at the time of operation were 34.8 years for the cannulated screw group and 36.6 years for the K-wire group. A vast majority of patients were males (78.6%). Involvement of the right side in the cannulated screw group was 57.1% and that in the K-wire group was 47.9%. Mean operative time was significantly shorter among the K-wire group (42 min) compared to the cannulated screw group (57 min). Mean AOFAS score was higher among the cannulated screw group (85.9 points) compared to the K-wire group (75.8 points). Final VAS was significantly better among the cannulated screw group compared to the K-wire group. Mean time of radiographic union in the cannulated screw group was 8.9 weeks and that in the K-wire group was 10.1 weeks. Conclusion Both techniques avoided wound complications associated with ORIF with the advantage of a shorter hospital stay. Patients in the cannulated screw group had better functional and radiographic outcomes and a lower rate of subtalar arthritis than patients in the K-wire group. K-wires had advantages of reduced operative time, and easy removal as an outpatient procedure.

Background:-Minimally invasive surgery in treatment of DIACFs has become popular among the international orthopaedics community to overcome the soft tissue complications associated with the standard ORIF through extensile lateral approach. Objective:-The current study's objective was evaluation of the functional and radiographic outcomes of closed reduction and percutaneous cannulated screws fixation of DIACFs compared with the standard ORIF by calcaneal locked plate using an extensile lateral approach. Patients and methods:-35 patients with unilateral DIACFs from June 2019 to May 2022 were retrospectively reviewed. The Percutaneous cannulated screws group included 17 patients, and the ORIF group included 18 patients. Radiographic assessment included calcaneal height, length, and width, Böhler's angle, angle of Gissane, and posterior facet inclination angle. Clinical assessment by the AOFAS ankle-hindfoot score and the visual analog pain score was done. Results:-No appreciable differences were noticed in the pre-operative and post-operative radiographic parameters measurements, and the final AOFAS ankle-hindfoot scores between the two groups. The pain scores were lowered significantly in the percutaneous cannulated screws group, (P = 0.0364). Conclusion:-Percutaneous cannulated screws had achieved radiographic and functional outcomes comparable to ORIF in management of DIACFs with lower complication rates.

Background: Treatment of displaced intra-articular calcaneal fractures (DIACFs) remains controversial and challenging to orthopaedic surgeons. Several procedures were used to treat DIACFs. There is no single approach that is universally applicable to all DIACFs. Objective:-The aim of this prospective study was to evaluate functional and radiographic outcomes of closed reduction and percutaneous cannulated screws fixation in treatment of Sanders type II & III DIACFs. Patients and methods: A prospective study was conducted on 14 patients (17 feet) with Sanders' type II or III DIACFs, treated by closed reduction and fixation using cannulated screws, at orthopedics department of Sohag university hospital, between June 2020 and April 2022. Functional assessment was done by AOFAS score and VAS for pain. Radiographic assessment was done by measurement of three calcaneal angles (Gissane, Böhler's and posterior facet inclination angles) and three calcaneal distances (height, length and width of calcaneus).Results: The mean age of patients at time of operation was 34.8 years. Vast majority of patients were males (78.6%). Involvement of right side was 57.1%. Mean operative time was 57 minutes. Mean AOFAS score was 85.9 points. Mean time of radiographic union was 8.9 weeks. Conclusion: The technique avoided wound complications associated with ORIF with advantage of shorter hospital stay. Patients are satisfied and had lower rate of subtalar arthritis.