Related Experiment Video
Updated: Dec 11, 2025
Treatment with Locking Intramedullary Nailing for Intertrochanteric Fracture of the Femur Utilizing a New Awl with a Distal Positioner
Published on: June 6, 2025
Comparison of 5 Treatment Approaches for Displaced Intra-articular Calcaneal Fractures: A Systematic Review and
FangLing Shi1, ShiYuan Wu2, Wei Cai1
1Resident, Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China; Resident, The Second School of Medicine, Wenzhou Medical University, Wenzhou, Zhejiang, China.
This network meta-analysis found minimally invasive longitudinal approach (MILA) effective for displaced intra-articular calcaneal fractures (DIACFs). MILA offers a good alternative with favorable radiographic and clinical outcomes, and fewer incision complications.
Area of Science:
- Orthopedic Surgery
- Traumatology
- Evidence-Based Medicine
Background:
- Treatment of displaced intra-articular calcaneal fractures (DIACFs) is complex and treatment choice remains debated.
- Existing evidence comparing various surgical and nonoperative methods for DIACFs is fragmented.
- A comprehensive analysis is needed to guide optimal treatment selection for DIACFs.
Purpose of the Study:
- To compare radiographic characteristics, clinical effectiveness, and incision complications of different treatments for DIACFs.
- To evaluate nonoperative treatment, open reduction and internal fixation (ORIF), and minimally invasive reduction and fixation techniques.
- To rank treatment options based on network meta-analysis of randomized controlled trials (RCTs).
Main Methods:
- Systematic literature search of Medline, Embase, Google Scholar, and Cochrane Central Register of Controlled Trials.
- Inclusion of seventeen randomized controlled trials (RCTs) involving 1297 participants and 1354 fractures.
- Analysis of five treatment groups: extensile lateral approach (ELA), minimally invasive longitudinal approach (MILA), sinus tarsi approach (STA), percutaneous reduction and fixation (PRF), and nonoperative treatment.
Main Results:
- MILA showed superior recovery of Böhler's angle. PRF and ELA demonstrated better Böhler's angle post-treatment.
- Percutaneous reduction and fixation (PRF) yielded the highest American Orthopaedic Foot & Ankle Society (AOFAS) scores.
- Sinus tarsi approach (STA) reported the highest satisfaction ratings, while PRF and MILA had significantly higher incision complication rates compared to ELA and STA.
Conclusions:
- Minimally invasive approaches, particularly MILA, present a viable alternative for DIACFs due to favorable radiographic and clinical outcomes.
- While PRF offers good functional scores, it is associated with higher complication rates.
- Further high-quality RCTs are recommended to solidify conclusions regarding the optimal management of DIACFs.
