Comparison of three surgical methods in the treatment of displaced intra-articular calcaneal fractures: A retrospective study.

Abstract

To compare the efficacy of three surgical methods-Robot-Assisted Percutaneous Reduction and Screw Fixation (RA-PRSF), Sinus Tarsi Approach for Open Reduction and Plate Fixation (STA-ORPF), and Extended Lateral Approach for Open Reduction and Plate Fixation (ELA-ORPF)-in the treatment of displaced intra-articular calcaneal fractures (DIACFs). A retrospective cohort study was conducted involving 190 patients (202 fractures) with Sanders type II or III DIACFs. Patients were divided into three groups based on the surgical method. Perioperative outcomes, radiological parameters, functional scores, and complication rates were compared. All three groups achieved comparable radiological outcomes and final AOFAS and VAS scores. However, the RA-PRSF group demonstrated significant advantages in intraoperative blood loss, weight-bearing time, and early functional recovery (AOFAS at 3 months, P < 0.001). The ELA-ORPF group had the highest wound complication rate (12.2%), significantly greater than the RA-PRSF (0%) and STA-ORPF (1.8%) groups (P < 0.05). No significant differences were observed in overall complication rates. While all three methods are effective for DIACF management, RA-PRSF offers superior perioperative outcomes and early recovery with minimal soft tissue complications. STA-ORPF provides a balanced minimally invasive alternative, whereas ELA-ORPF, though effective, carries a higher risk of wound complications.