Percutaneous Prodding Reduction and K-Wire Fixation Via Sinus Tarsi Approach Versus ORIF for Sanders Type III Calcaneal Fractures: A Prospective Case-Controlled Trial.

We conducted a prospective randomized controlled trial to compare the radiological and clinical outcomes of Sanders type III calcaneal fractures treated with percutaneous prodding reduction and K-wire fixation via a sinus tarsi approach (PPRKF) versus open reduction and internal fixation (ORIF). Fifty-one patients with closed, unilateral, Sanders type III calcaneal fractures were randomly assigned to the PPRKF group (n = 26) or the ORIF group (n = 25). The clinical outcomes evaluated were time to surgery, blood loss, operative time, hospital stay, wound healing time, wound complications, and Maryland foot score. Radiological results were evaluated on lateral and axial X-rays and computed tomography images and included Böhler's angle, Gissane's angle, and calcaneal width. Compared with the ORIF group, the PPRKF group had shorter time to surgery, shorter operative time, less blood loss, shorter hospital stay, shorter wound healing time, and fewer wound complications (p < .001). The postoperative Böhler's angle, Gissane's angle, and calcaneal width in both groups were significantly better than those measured preoperatively (p < .001) and did not differ between the PPRKF group and ORIF group (p> .05). Regarding clinical results, there was no significant difference in Maryland foot score between the two groups at 12 months after surgery (p > .05). Both PPRKF and ORIF can result in satisfactory clinical function. PPRKF is superior to ORIF in reducing the time to surgery, operative time, blood loss, hospital stay, wound healing time, and wound complications.

Case Report: Bosworth Fracture-Dislocation managed by Closed Reduction and Conservative Treatment.

Bosworth fracture-dislocation is a rare type of ankle injury, which in the typical radiologic are overlap of distal tibia and fibula in the anteroposterior view, posterior subluxation of the talus and syndesmosis dissociation in the lateral view, while in the CT scan, the fibula was displaced behind the posterior edge of the fibular notch (incisura tibiae), locked between the distal tibia and the displaced posterior malleolus fragment. Treatment can be challenging owing to the ignorance or failure of the initial reduction, resulting in an irreducible tibiotalar joint and tibiofibular syndesmosis reduction. To treat this complicated injury, emergent open surgery is always recommended for the first stage reduction to prevent adverse events. Successful closed reduction and conservative treatment of Bosworth fracture-dislocation is rare. This unique case presents a 25-year-old male with a Bosworth fracture-dislocation cured with closed reduction and U-shaped plaster splint. The patient was fully weight bearing and had no pain, and there were no limitations in the range of motion of the ankle and subtalar joints at 30 months of follow-up.