This study is to compare clinical outcome of Sanders type III or IV intra-articular calcaneal fracture treated with open reduction and internal fixation (ORIF) versus ORIF and primary subtalar arthrodesis (PSTA).
Sanders type 3 and 4 intra articular calcaneal fracture within 14 day of injury
patient with open injury, concomitant foot injury, vascular compromise and prior subtalar pathology
Parallel
Primary Subtalar Arthrodesis
Procedure/SurgeryPatients undergo primary subtalar arthrodesis via an extended lateral approach. The articular cartilage of the subtalar joint is removed, the calcaneal morphology is restored, and fixation is achieved using cannulated compression screws with a locking plate. Postoperative care follows the same protocol as the ORIF group. This intervention is distinguished from other surgical techniques by performing fusion as the primary treatment in severely comminuted Sanders type III and IV fractures, aiming to reduce the risk of post-traumatic subtalar arthritis.
Open reduction and internal fixation
Procedure/SurgeryPatients undergo open reduction and internal fixation of displaced intra-articular calcaneal fractures through an extended lateral approach. Fracture reduction is achieved under fluoroscopic guidance, restoring Bohler's and Gissane's angles. Fixation is performed using a locking calcaneal plate with screws. Postoperative care includes immobilization in a cast or splint, non-weight bearing for 8 weeks, followed by a standardized physiotherapy program. This procedure is distinguished from other calcaneal fracture treatments by the use of locking plate technology and precise anatomical reduction for Sanders type III and IV fractures
Orthopedic foot and ankle AOFAS
Orthopedic foot and ankle score (AOFAS)
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Ahmed Gamal Ibrahim Saleh
Lead sponsor
Al-Azhar University
Sponsor institution
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